- 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
- GEHA (Lee's Summit, MO)
- …conjunction with the Vice President and Director of Pharmacy to align Medicare Part D / EGWP lines of business to organizational goals and initiatives. ... a personalized customer experience, sustained by a nimble and efficient organization. The Medicare Part D Performance Management Specialist will report to… more
- Healthfirst (NY)
- … Clinical Programming and Operations, Provider Performance, Medical and Pharmacy Part D cost savings, and Medicare Star Ratings/member experience. ... Programming and Operations + Provider performance + Medical and Pharmacy Part D cost savings + Medicare Star Ratings/member experience. **Compliance &… more
- Adecco US, Inc. (Houston, TX)
- …email . Understand the overall business model of Medicare Part D products, CMS guidance, the Pharmacy Benefit Manager (PBM) claim adjudication system and ... external clients. **Qualifications:** . High school diploma or GED . 3 years Medicare Part D / Pharmacy benefit, and/or PBM experience related to… more
- CVS Health (Blue Bell, PA)
- …skills + Solid technical/analytical skills and attention to detail Preferred Qualifications + Previous Pharmacy , Medicare Part D , Medicare experience ... CVS Health and Aetna's exciting and growing government services pharmacy business. This role will focus on analyzing financial...financial and business impacts of changes to the complex Part D market and completive landscape. The… more
- BlueCross BlueShield of North Carolina (NC)
- …strategic thought leadership relating but not limited to pharmacy network, formulary, and Medicare Part D topics + Manage relationship with external ... **Job Description** This Consulting Actuary with a Medicare Part D focus on the Medicare Pricing team, will provide pricing, forecasting, and strategic… more
- CVS Health (Chicago, IL)
- …skills and attention to detail Preferred Qualifications + Previous Pharmacy or Medicare Part D experience + FSA designation + Experience with ... CVS Health and Aetna's exciting and growing government services pharmacy business. The primary focus is the pharmacy...role will focus on developing health care solutions for Medicare Part D members. The… more
- CVS Health (Chicago, IL)
- …+ Comfortable working in a fast-paced environment with constant change Preferred Qualifications + Prior Pharmacy , Medicare Part D , Medicare or ... actuarial team supporting CVS Health and Aetna's Government Services Medicare Advantage and Prescription Drug Plan business. The position...position will provide modelling and analytical support for the Part D Business, with a focus on… more
- Catholic Health Initiatives (Bismarck, ND)
- …basis as required for Medicare Part B and Medicare Part D . + Actively participates in retail pharmacy operations. + Maintaining confidentiality ... throughout western and central North Dakota. CHI St. Alexius Health is part of CommonSpirit Health, a nonprofit, Catholic health system dedicated to advancing… more
- Molina Healthcare (Owensboro, 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: $19.64 - $42.55 / HOURLY *Actual compensation may vary… 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
- 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
- Prime Therapeutics (Columbus, OH)
- …our passion and drives every decision we make. **Job Posting Title** Principal Actuary - Medicare Part D - Remote **Job Description** The Principal Actuary ... projections + Lead, manage, and review ad hoc complex pharmacy data mining and analyses to help investigate and...healthcare organization or PBM + Previous experience pricing Commercial, Medicare or Medicaid lines of businesses + 5 years… more
- Centene Corporation (Phoenix, AZ)
- …following areas: Formulary Management, Pharmacy Audit and Recovery, Pharmacy Service Center, Medicare Part D / Part B, Appeals, Medicare ... D Operations and State Health Programs Pharmacy Operations or Prior Authorization. Using established company guidelines,...Regional Medical Director on related issues. + Prior Authorization Medicare Part D and … more
- The Cigna Group (Tampa, FL)
- …Pharmacy Technician in the Stars Pharmacy Call Center will work within the Part D Medication Adherence area of the Cigna Medicare Stars department. ... to overcome those barriers by working with the clinical pharmacy team, physicians, and resources within the Medicare... pharmacy team, physicians, and resources within the Medicare Health Plan. Primary Responsibilities include but are not… 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 ... information and completing timely and accurate documentation of all Medicare Part D requests, in...Access, Power Point, and Visio. **Education:** Bachelor's degree in pharmacy or Pharm D . required, with at… more
- Healthfirst (NY)
- …appropriate access to prescription drug benefit + Review CMS communications related to Medicare Part D and leads implementation/response planning. + ... for Medicare products. + Leads the setup and monitoring of Medicare pharmacy benefits and PDE accuracy in collaboration with our Pharmacy Benefit… more
- CareFirst (Baltimore, MD)
- …activities. + Experience with developing and implementing clinical programs. + Experience with Medicare Part D and Medicaid guidelines and requirements. + ... pharmacy vision and strategic plan for government programs ( Medicare and Medicaid). This role has oversight of ...Medicare and Medicaid). This role has oversight of pharmacy staff and develops and maintains collaborative relationships with… 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