- KPH Healthcare Services, Inc. (East Syracuse, NY)
- **Overview** **The selected candidate must have** **5+ years experience in Medicare Part D and/or EGWP programs.** **Scope of Responsibilities:** Provides ... oversight and management of Medicare Part D /EGWP program. **Job...of new or changed rules and/or regulations + Identify performance and compliance risks and communicates to leadership and/or… more
- Walworth County (Elkhorn, WI)
- …This position is responsible for assisting Medicare beneficiaries with enrollment issues regarding Medicare Part D , Medicare Part C (Advantage ... or restrict the tasks that may be assigned. Perform Medicare Part D drug assessments...direction is available as requested. These decisions directly impact performance in the job and/or the work unit within… more
- The Cigna Group (Houston, TX)
- …Technician in the Stars Pharmacy Call Center will work within the Part D Medication Adherence area of the Cigna Medicare Stars department. The Star rating ... system was developed by the Centers for Medicare & Medicaid Services (CMS) to measure the quality...+ Meet service level goals (call quality, daily/weekly call performance expectations). + Maintain member privacy by strictly adhering… more
- Elevance Health (Atlanta, GA)
- …regulations for program areas including but not limited to: claims, grievances and appeals, Part D and risk adjustment. + Knowledge of Risk Adjustment Payment ... with direct reports. + Hires, trains, coaches, counsels, and evaluates performance of direct reports. **Position Requirements** Requires a BA/BS and a… more
- Central Maine Medical Center (Lewiston, ME)
- …principles for inter/intra departmental interactions.c) Develops tools and collects data as indicated. d ) Uses data to drive Performance Improvement: able to ... staff and other department managers.c) Creates and sustains a culture of safety. d ) Leads and manages change effectively.e) Responds to change productively, promotes… more
- Commonwealth of Pennsylvania (PA)
- …eligibility for benefits, and assisting with the completion of forms/applications (such as PACE/PACENet, Medicare / Medicare Part D , Property, Tax & Rent ... Aging Case Aide 2 (Local Government) ( Part -Time) - Luzerne/Wyoming County Area Agency on Aging...each question carefully. Determine and select which "Level of Performance " most closely represents your highest level of experience/training.… more
- Humana (Columbus, OH)
- …Policies and Procedures, and clinical literature as appropriate. Medical Directors will learn Medicare Part D and Medicare Advantage requirements ... Medical Director relies on broad clinical expertise to review Medicare drug appeals ( Part D ...This incentive opportunity is based upon company and/or individual performance . **Description of Benefits** Humana, Inc. and its affiliated… more
- Humana (Columbus, OH)
- …management, optimizing Medicaid performance and ensuring alignment with Medicare and other Enterprise leaders. **Unified D -SNP Market Leadership** ... **Become a part of our caring community and help us...by providing a single point of accountability for Medicaid D -SNP market performance and strategy **Strategic Execution… more
- Humana (Columbus, OH)
- …+ Lead actuary owns responses related to Part B pharmacy projection and Part D bid base period development. + Coordinates with data suppliers and compliance ... substantial. Part B Pharmacy Pricing **Lead Actuary** Part B Pharmacy Pricing + Own the Medicare...This incentive opportunity is based upon company and/or individual performance . **Description of Benefits** Humana, Inc. and its affiliated… more
- Humana (Columbus, OH)
- …to exercise independent judgment and thinking on complex issues **Preferred Qualifications** + Medicare Advantage and/or Part D experience + Demonstrated ... **Become a part of our caring community and help us...the Senior Products Actuarial Compliance team focused on special Medicare Advantage programs, including Value Based Insurance Design (VBID),… more
- G-TECH Services, Inc. (Detroit, MI)
- …dashboard. * Assist with all functions related to Pharmacy Benefit Manager (PBM) oversight for Medicare Advantage Part D plans. * Receive and respond to plan ... regulations. * Performs routine tracking, auditing, and reporting of performance in relation to CMS requirements. * Supports the...Required Skills * Working knowledge of Medicare Part B and Part D … more
- Commonwealth of Pennsylvania (PA)
- …necessary. Assists with completing various applications for assistance (ie, APPRISE, PACE/PACENET, Medicare , SNAP, etc.). Levels of Performance Select the "Level ... obtain needed information from consumers and caregivers. Apply today to become an essential part of our team as you support all functions of Care Management in the… more
- The MITRE Corporation (Mclean, VA)
- …the public interest, with no commercial conflicts to influence what we do. The R& D centers we operate for the government create lasting impact in fields as diverse ... MD locations. The Division is responsible for the overall performance of the work programs across key components of...key components of MITRE's portfolio with the Centers for Medicare & Medicaid Services (CMS), including the Center for… more
- Healthfirst (NY)
- …and other data analytics for Medicare products + Assist in the Medicare Part C and Part D bid process, including bid preparation and desk review ... follow-ups + Monitoring experience and analyzing performance of Medicare products + Other ad-hoc analysis on Medicare products **Required Qualifications:** +… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …3. Support our Medicare Enrollment teams ( Medicare Advantage, Medex, and our Part D PDP teams) by cross training on other enrollment functions and assist ... by visiting our Company Culture (https://careers.bluecrossma.org/us/en/culturepage) page. If this sounds like something you' d like to be a part of, we' d love… more
- AdventHealth (Rome, GA)
- …+ Career Development + **Our promise to you:** Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the ... the AONE Nurse Executive Competencies 1. **Human Resource Management** - Monitors performance of the staff and takes corrective action for improvement as… more
- Marshfield Clinic (Eau Claire, WI)
- …Center:** 301081251 Systems Operations **Scheduled Weekly Hours:** 4 **Time Type:** Part time **Job Description:** **POSITION TITLE:** Assistant Service Line Medical ... for service line physicians c. Annual review of Advanced Practice Clinicians d . Market share/specialty planning, including outreach e. Budget and financial … more
- Humana (Stevens Point, WI)
- **Become a part of our caring community and help us put health first** The Regional VP, Health Services will provide medical leadership and strategy for the Health ... Services Operations, which includes: Care Management for D -SNP, BadgerCare+, and SSI contracts; Quality and Population Health functions; Prior Auth and Utilization… more
- VNS Health (Manhattan, NY)
- …resolve discrepancies to reduce financial and compliance risks to the plan. + Monitors Medicare Part D Reconciliation activities related to Prescription Drug ... Mainframe) to ensure timeliness of applicant and member correspondences. Designs performance indicator reports based on analyses of compliance findings. Makes… more
- State of Colorado (Golden, CO)
- TEMPORARY AIDE- Part Time Correctional Security Officer- Lookout Mountain Campus Print (https://www.governmentjobs.com/careers/colorado/jobs/newprint/4714507) Apply ... TEMPORARY AIDE- Part Time Correctional Security Officer- Lookout Mountain Campus Salary...levels and employees must frequently climb stairs in the performance of job duties. Please take into account your… more