- Insmed Incorporated (Los Angeles, CA)
- …Product launch experience preferred Experience navigating payer reimbursement process, preferably Medicare Part D ( pharmacy benefit design and coverage policy) ... in - reimbursement and patient access, market access, specialty pharmacy , or physician/system account management Bachelor's degree required Experience working… more
- 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 ... Lead drafting and negotiating contracts for commercial, Medicaid and Medicare coverage, as well as other government contracts, trade/distribution agreements,… more
- Eisai, Inc (Boston, MA)
- …to regional and corporate partners, including customer feedback, payer coverage (medical/ pharmacy benefit), and access to product procurement. This role will also ... not limited to the following: Practice Mangers, Financial Counselors, Pharmacy Managers/Directors, Business Administrators, State Societies, and DME/MAC personnel.… more
- Daiichi Sankyo, Inc. (Boston, MA)
- …landscape, the appropriate utilization of NCCN/ASCO guidelines, private payer, GPOs, Medicare and Medicaid structure, Specialty Pharmacy systems and ... but not limited to: benefits investigations, financial assistance options, and Specialty Pharmacy issues. They will also provide education on relevant health care… more
- Daiichi Sankyo, Inc. (Seattle, WA)
- …landscape, the appropriate utilization of NCCN/ASCO guidelines, private payer, GPOs, Medicare and Medicaid structure, Specialty Pharmacy systems and ... but not limited to: benefits investigations, financial assistance options, and Specialty Pharmacy issues. They will also provide education on relevant health care… more
- Merck & Co. (North Wales, PA)
- …and contract responsibility across the entire US health care system: Pharmacy Benefit Managers, Health Plans, State Medicaid agencies, Integrated Delivery Networks, ... Hospital Systems, Group Purchasing Organizations, Federal agencies, Pharmacy /Wholesalers, and Infusion companies for our Company's commercial and government… more
- Medical Mutual of Ohio (OH)
- …remote opportunity_** . **_Eastern & Central Time Zones preferred._** **Responsibilities** ** Medicare Pharmacy Coordinator I** Working under general supervision, ... (medical drug) programs as needed. . Performs other duties as assigned. ** Medicare Pharmacy Coordinator II** Working under general supervision, administers… more
- Healthfirst (NY)
- … Medicare 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 ...and Pharmacy Part D cost savings + Medicare Star Ratings/member experience. **Compliance & Regulatory Responsibilities:** Noted… more
- The Cigna Group (Tampa, FL)
- …adherence and working to overcome those barriers by working with the clinical pharmacy team, physicians, and resources within the Medicare Health Plan. Primary ... **What will I be doing?** The Pharmacy Technician in the Stars Pharmacy ...the Part D Medication Adherence area of the Cigna Medicare Stars department. The Star rating system was developed… more
- GEHA (Lee's Summit, MO)
- …and regulatory requirements. + Work in conjunction with the Vice President and Director of Pharmacy to align Medicare Part D / EGWP lines of business to ... personalized customer experience, sustained by a nimble and efficient organization. The Medicare Part D Performance Management Specialist will report to the Director… more
- CVS Health (Blue Bell, PA)
- …+ Solid technical/analytical skills and attention to detail Preferred Qualifications + Previous Pharmacy , Medicare Part D, Medicare experience + ASA or ... team supporting CVS Health and Aetna's exciting and growing government services pharmacy business. This role will focus on analyzing financial and business impacts… more
- Molina Healthcare (Bowling Green, KY)
- **JOB DESCRIPTION** **Job Summary** Molina Pharmacy Services/Management staff work to ensure that Molina members, providers, and pharmacies have access to all ... These jobs are responsible for creating, operating, and monitoring Molina Health Plan's pharmacy benefit programs in accordance with all federal and state laws. Jobs… more
- Specialty Rx, Inc. (Ridgefield Park, NJ)
- Job Description SpecialtyRx is a full-service pharmacy . We need Medicare Part B- Billing Representative with Pharmacy experience in our Ridgefield Park, NJ ... equivalent. + Computer literate. + Previous experience in Retail pharmacy is a must. + Experience in Long Term...is a must. + Experience in Long Term Care Pharmacy . (Preferred) + Must be able to work independently… more
- Healthfirst (NY)
- …and workflows for Medicare products. + Leads the setup and monitoring of Medicare pharmacy benefits and PDE accuracy in collaboration with our Pharmacy ... Identifies opportunity for operational improvement and leads the development of new pharmacy benefit capabilities to maximize performance. + Leads the development of… more
- BlueCross BlueShield of North Carolina (NC)
- …+ Provide proactive and strategic thought leadership relating but not limited to pharmacy network, formulary, and Medicare Part D topics + Manage relationship ... **Job Description** This Consulting Actuary with a Medicare Part D focus on the Medicare...with external Pharmacy Benefits Manager as primary point of contact +… more
- Centene Corporation (Phoenix, AZ)
- …more of the following areas: Formulary Management, Pharmacy Audit and Recovery, Pharmacy Service Center, Medicare Part D/Part B, Appeals, Medicare Part ... Operations or Prior Authorization. Using established company guidelines, the Pharmacy Technician reviews requests made by physicians, medical groups, pharmacies and… more
- Actalent (Mcallen, TX)
- …coverage determination request decisions Skills: medical, medical terminology, health care, medicare , Pharmacy , Cpht, Pharmacy technician certification, ... Pharmacy technician certificate Top Skills Details: medical,medical terminology,health care, medicare , Pharmacy ,Cpht, Pharmacy technician certification,Prior authorization,Retail … more
- Trinity Health (Fort Wayne, IN)
- …authorizations when benefit investigation is not required; resolves aspects of specialty pharmacy insurances, including Medicare , Medicaid, PBM, and PPO and ... - located in Fort Wayne, Indiana** The Patient Assistance Pharmacy Technician in Training will participate in a work...in a work learning program to become a licensed pharmacy technician in the state of Indiana and trained… more
- Molina Healthcare (Long Beach, CA)
- …development, provider contracting experience. + Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, capitation, ... providers and medical managers regarding utilization practices, guideline usage, pharmacy utilization and effective resource management. + Develops and implements… more
- CVS Health (Phoenix, AZ)
- …and affordable. **Position Summary** - Supports comprehensive coordination of Medicaid and/or Medicare pharmacy services including intake and processing of ... requests. - Promotes and supports quality effectiveness of healthcare and Pharmacy Services. - Evaluates, authorizes approval, and communicates decisions for … more
