- Medical Mutual of Ohio (OH)
- …general supervision, administers standardized to moderately complex daily operations in compliance with the Medicare Part D ( pharmacy ) and Medicare ... material requirements. . Assists in internal and external audits and projects of the Medicare Part D ( pharmacy ) and Part C (medical drug) programs as… more
- US Tech Solutions (May, OK)
- …criteria based prior authorizations as per policy and procedure. **Skills:** Prior Authorization Medicare Part D Pharmacy Benefit Management (PBM) ... Ideal candidates must have experience of Prior Authorization, Medicare Part D and Pharmacy Benefit Management experience.** **Job Description:** This… more
- Molina Healthcare (KY)
- …legal processes (Commercial insurance, Medicare , Medicare Advantage, Medicare Part D , Medicaid, Tricare, Pharmacy , etc.) + Experience with UNET, ... and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/ D /V. Pay Range: $21.82 - $51.06 / HOURLY *Actual compensation may vary… more
- US Tech Solutions (May, OK)
- …of experienced with Prior Authorization(required). + MUST HAVE experience with Medicare Part D + Must Have Pharmacy Benefit Management (PBM) experience. ... and procedure. **Experience:** + Prior authorization experience required. + Previous pharmacy experience in retail or hospital preferred. + Appropriate state license… more
- 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...(eg Plan Sponsor), daily operations, and implementation of EGWP pharmacy programs + Understand service agreements and terms between… more
- Elevance Health (Columbus, OH)
- …specifically for Part D . -Experience in a pharmacy benefit management organization leading accounts, preferably Medicare accounts. -Exceptional ... will make an impact: + Handling a variety of Medicare pharmacy accounts. + Utilizing strong account...and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within… more
- Corewell Health (Grand Rapids, MI)
- …Disease (SPC), Medication Therapy Management (MTM), and CAHPS + Educate patients on their Medicare Part D benefits and drug coverage to increase ... Manager of Medicare Quality of Director of Medicare Pharmacy Qualifications Required + Doctorate Doctor...Power Point + Ability to work independently and as part of a team + Comfortable with change +… more
- CareFirst (Owings Mills, MD)
- …Coverage (EOC) / Annual Notice of Change (ANOC); Explanation of Benefits (EOB); Part D sponsor websites (CVS/Caremark Websites); Notification Prior to Point of ... systems analysis, testing or other analytical experience. **Preferred Qualifications:** + Medicare Prescription / Pharmacy experience. + Demonstrated ability to… more
- Humana (Columbus, OH)
- …in-depth evaluation of variable factors. The focus of this role is Medicare Pharmacy and Part D . The Senior Compliance Professional will analyze business ... **Become a part of our caring community and help us...Plan Compliance or Health Plan Operations + Familiarity with Medicare pharmacy laws or regulations **Additional Information**… more
- Catholic Health Initiatives (Bismarck, ND)
- …training on an annual basis as required for Medicare Part B and Medicare Part D + Participates in dispensing of pharmaceutical products and supplies ... throughout western and central North Dakota. CHI St. Alexius Health is part of CommonSpirit Health, a nonprofit, Catholic health system dedicated to advancing… more
- University of Michigan (Ann Arbor, MI)
- …insurance company policies and requirements (ie Medicare , Social Security, Medicaid, and Medicare Part D ). + Ability to handle time-sensitive information ... Specialty Pharmacy Patient Financial Counselor Apply Now **How to...medical office setting. + Ability to work well as part of a team and with minimal supervision, consistently… more
- Walgreens (Deerfield, IL)
- …segments. In addition, experience with billing procedures for hospital, medical offices and Medicare (B / D benefits). + Experience with analyzing and reporting ... Description:** **Job Summary:** Responsible for the promotion of Walgreen's specialty pharmacy services to targeted physicians, nurses, practice managers and other… more
- BrightSpring Health Services (Taunton, MA)
- …+ Researches, analyzes and appropriately resolves rejected claims by working with national Medicare D plans, third party insurance companies and all state ... pharmaceutical support they need. We offer a non-retail, closed-door pharmacy environment, allowing you to focus on what truly...get the support they need. + Be a vital part of a team that's dedicated to enhancing patient… more
- AdventHealth (Bolingbrook, IL)
- …controlled substance oversight, and billing including, Long Term Care (LTC) billing and Medicare D claim adjudication. * Serves as a resource for automation ... Resources and Support **Our promise to you:** Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in… more
- AdventHealth (Glendale Heights, IL)
- …controlled substance oversight, and billing including, Long Term Care (LTC) billing and Medicare D claim adjudication. * Serves as a resource for automation ... tuition expense) **Our promise to you:** Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes… more
- Adecco US, Inc. (Scottsdale, AZ)
- Pharmacy Benefits Representatives Wanted! Adecco is actively recruiting Pharmacy Benefits Representatives in Scottsdale, Arizona to become a part of a ... Apply today! **Requirements:** - Must have 1+ year of experience processing pharmacy benefits in a call center setting (Prior authorizations, Rx refills, verifying… more
- CVS Health (Columbus, OH)
- …a market leader in mail order, retail and specialty pharmacy , retail clinics, and Medicare Part D Prescription Drug Plans. As a pharmacy innovation ... helping people on their path to better health as part of the largest integrated pharmacy company...support contract and legal adherence with all payers including Medicare and Medicaid. Identify and implement process efficiencies across… more
- US Tech Solutions (May, OK)
- **Job Description:** + As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy ... by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines,… 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
- BrightSpring Health Services (Wallingford, CT)
- …disposing of drugs + Performs other tasks as assigned Qualifications + Bachelor's Degree in Pharmacy ; Pharm D preferred + One year experience in long-term care + ... Our Company OnePoint Patient Care Overview Our Pharmacy group focuses on providing exceptional customer service...pharmacies to begin serving the hospice industry when the Medicare hospice benefit began in the 1980s. Today OnePoint… more