- Daiichi Sankyo, Inc. (Bernards, NJ)
- …but not limited to, areas of GPO/PBM and trade/distribution agreements, Medicare , Medicaid, product pricing, and government price reporting. Coordination with, and ... Company and/or departmental expectations and goals as identified by senior management.Responsibilities- Lead drafting and negotiating contracts for commercial,… more
- Novo Nordisk Inc. (WA)
- …and globally. Relationships Reports to the Market Access and Public Affairs Senior Director, Policy. Other internal relationships include a dotted line with ... could impact the pharmaceutical industry. Interactions frequently involve interactions with senior level leaders regarding matters of significance to NNI. Essential… more
- Novo Nordisk Inc. (Corona, CA)
- …level impact Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage ... I - $84,000 to $103,000 Diabetes Care Specialist II - $97,000 to $119,000 Senior Diabetes Care Specialist - $118,000 to $144,000 In addition, this position is… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …designates medical procedures/services based on relevant regulations and determinations. The Senior Medicare Coverage Analyst applies subject matter expertise to ... The Medicare Coverage Analyst (MCA) is responsible for reviewing...which should be billed to the study sponsor. The Medicare Coverage Analyst determines whether proposed clinical research studies… more
- Prime Healthcare (Ontario, CA)
- …Responsibilities The Senior Medicare ... education, credentials and licensure. Connect With Us! (https://careers-primehealthcare.icims.com/jobs/178464/ senior - medicare -medicaid-biller-collector/job?mode=apply&apply=yes&in\_iframe=1&hashed=-336024306) FacilityPrime Healthcare Management Inc… more
- CVS Health (Lansing, MI)
- …risks. The individual will work independently, as well as collaboratively, with internal senior level Medicare compliance and business teams that operate MMP and ... business, analytical and communication skills to support, manage and develop Medicare and Medicaid compliance programs and processes that promote compliant and… more
- Humana (Harrisburg, PA)
- …looking for licensed, highly motivated and self-driven individuals to join our team. Our Senior Manager, Medicare Sales motivates and drives a team of ... educate, motivate, train, and discipline a team of sales individuals. The Senior Manager, Medicare Sales must have a solid understanding of the market they… more
- The Cigna Group (Bloomfield, CT)
- …from Home for the right candidate.** Ability to travel up to 25%.** **OVERVIEW:** The Medicare Advantage (MA) Provider Operations Senior Director is a senior ... Medicare Operations Organization. This role will support the Medicare business (ie Individual & EGWP MAPD lines of...provider data and configuration changes for our regulated business ( Medicare Advantage, , etc.), to work with matrix partners… more
- Centene Corporation (Austin, TX)
- …that Medicare Compliance reports are provided regularly to the CRECO, the Medicare Compliance Committee, the Medicare Senior Leadership team and the ... **Position Purpose:** This position will be a member of Medicare & Compliance Senior Leadership, chairs Centene's Medicare Compliance Committee, attends… more
- Providence (OR)
- …the best people, we must empower them._** **Providence Health Plan is calling a Senior Actuarial Analyst, Medicare Bid who will:** + Be responsible for ... and providing strategic insights to support the pricing and bidding process for our Medicare Advantage plans + Have a deep understanding of Medicare Advantage… more
- Banner Health (UT)
- …8:00 AM - 5:00 PM (AZ Time). In this position you will be monitoring Medicare Advantage Parts C & D operational control measures ensuring appropriate oversight is in ... is in place for accurate, complete, and compliant for Medicare Advantage Parts C & D. + Identifying and...This position interacts with a multitude of executive and senior management, physicians and staff throughout Banner depending on… more
- Medical Mutual of Ohio (OH)
- …any oversight process questions. . Performs other duties as assigned. ** Senior Medicare Pharmacy Coordinator** Working under limited supervision, administers ... mail pharmacy. . Intermediate Microsoft Office skills (Excel, Word, Power Point). ** Senior Medicare Pharmacy Coordinator** . Associate Degree in Business… more
- Prime Healthcare (Redding, CA)
- …Responsibilities The Senior Medicare ... the specific payer guidelines, policies, procedures, and compliance regulations for Medicare -Medicaid. This includes maintaining the deficiency lists used to obtain… more
- Point32Health (Canton, MA)
- …are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Senior Manager of Product Implementation and Administration will have two main ... related filings, new benefit implementation, and product/vendor management processes. The Senior Manager will support annual assessment of new product strategies by… more
- Banner Health (AZ)
- …a direct interface with the Arizona Medicaid Agency (AHCCCS), Center of Medicare and Medicaid Services (CMS), Association for Community Affiliated Plans (ACAP), and ... the Arizona Association of Health Plans (AzAHP). CORE FUNCTIONS 1. Serves as the primary advisor to meet organization goals and objectives and has full budgetary accountability 2. Sets the department budget to meet organization goals and objectives and has… more
- CVS Health (Hartford, CT)
- …solutions to make health care more personal, convenient and affordable. As the Senior Manager, Medicare Duals Member Experience Project Management within the ... healthcare journey. **Fundamental Position Components:** + Provide direct leadership of the Medicare Member Advisory program and to ensure the collected feedback and… more
- CVS Health (Scottsdale, AZ)
- …We are seeking a dynamic and experienced leader to join our team as a Senior Manager, overseeing a team of 10 auditors. This role is pivotal in conducting and ... building Medicare Pharmacy Audit programs for our PBM clients. The...to the unique needs of our clients. As the Senior Manager, you will be responsible for developing and… more
- Elevance Health (Norfolk, VA)
- **Risk Adjustment Advanced Analyst Senior ** **Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of ... our Elevance Health PulsePoint locations.** The **Risk Adjustment Advanced Analyst Senior ** is responsible for creating statistical models to predict, classify,… more
- Centene Corporation (Austin, TX)
- …federal and state legal and regulatory requirements as it relates to Medicare compliance and HPMS/CMS regulations. + Oversee and monitor various of cross-functional ... policy concerning federal managed care regulations and initiatives. + Represent senior management at various committees, meetings, and seminars. + Communicate with… more
- Abt Global Inc. (Cambridge, MA)
- …add a talented researcher to its team of experts conducting policy-relevant Medicare and Medicaid research and evaluation. The successful candidate will leverage ... key technical roles on projects for the Centers for Medicare and Medicaid Services (CMS). As a member of...other post-acute care settings, health care policy. + Use Medicare claims data to create measures of quality, utilization,… more
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