- CVS Health (Phoenix, AZ)
- …do it all with heart, each and every day. **Position Summary** The Aetna Managed Medicaid Fellowship introduces two pharmacists to the health plan side of ... Aetna/CVS Health(R) leaders with exposure to projects across variety of Medicaid Pharmacy shared services teams and individual health plans. Throughout the year,… more
- Humana (Indianapolis, IN)
- …and other reference sources. Medical Directors will learn North Central region state Medicaid requirements (currently VA, KY, OH, IN, WI) and will understand how to ... of coding practices and clinical documentation, grievance and appeals processes (including pharmacy ), and reviews for DME, genetic testing, etc. within their scope.… more
- Humana (Lincoln, NE)
- …National and Local Coverage Determinations, CMS-recognized Compendia, NCCN, Humana Pharmacy Policies and Procedures, and clinical literature as appropriate. Medical ... 5+ years of direct clinical patient care experience post residency or fellowship , preferably including some experience related to a Medicare type population… more
- J&J Family of Companies (Titusville, NJ)
- …Organizations (MCOs), large physician groups, Group Purchasing Organizations (GPOs), Pharmacy Benefit Management (PBM) companies, Governmental Agencies (CMS and ... VA/DoD System), Medicare, Medicaid , Long Term Care (LTC) facilities, Integrated Delivery Networks (IDNs), and Accountable Care Organizations (ACOs) in the assigned… more
- UTMB Health (Galveston, TX)
- …next generation of geriatricians through its ACGME-accredited Geriatric Medicine Fellowship Program, which offers robust inpatient and outpatient experiences, ... care that encompasses evidence-based practice guidelines, practice protocols, Medicare, Medicaid , and other state and federal regulations. *Prescribes appropriate… more
- CenterWell (Boston, MA)
- …5+ years of direct clinical patient care experience post residency or fellowship , which preferably includes some experience in an inpatient environment and/or ... of the managed care industry including Medicare Advantage, Managed Medicaid and/or Commercial products, or other medical management organizations, hospitals/… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …the Medical Services area including, but not limited to, Medical and Pharmacy Utilization Management, quality management, member care management, and medical policy ... after completion of all graduate medical education training, including residency and fellowship (when applicable). + Medical Degree: MD or DO from an accredited… more