- GEHA (Lee's Summit, MO)
- …and a personalized customer experience, sustained by a nimble and efficient organization. The Medicare Part D Performance Management Specialist will ... for monitoring contractual, operational, reporting, and regulatory requirements for Medicare Part D / EGWP...EGWP on all lines of business. + Monitor key performance indicators in clinical, operational, and vendor management areas… more
- CenterWell (Columbus, OH)
- …performance improvement activities and align pharmacy services with improvement quality metrics and Medicare part D performance . + Collaborate with ... **Become a part of our caring community and help us...current knowledge of pharmacy/medical trends within ambulatory/primary care and Medicare **Use your skills to make an impact** **Required… 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...of new or changed rules and/or regulations + Identify performance and compliance risks and communicates to leadership and/or… more
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** This Consulting Actuary with a Medicare Part D focus on the Medicare Pricing team, will provide pricing, forecasting, and strategic ... Medicare products with a particular emphasis on Medicare Part D . You will...such as competitive health benefits, bonus plans based on performance , 401(k) with employer match, paid time off (plus… more
- Healthfirst (NY)
- …areas such as Risk Score Accuracy, Medicare Clinical Programming and Operations, Provider Performance , Medical and Pharmacy Part D cost savings, and ... Programming and Operations + Provider performance + Medical and Pharmacy Part D cost savings + Medicare Star Ratings/member experience. **Compliance &… more
- Walworth County (Elkhorn, WI)
- …This position is responsible for assisting Medicare beneficiaries with enrollment issues regarding Medicare Part D , Medicare Part C (Advantage ... or restrict the tasks that may be assigned. Perform Medicare Part D drug assessments...direction is available as requested. These decisions directly impact performance in the job and/or the work unit within… more
- Central Maine Medical Center (Lewiston, ME)
- …principles for inter/intra departmental interactions.c) Develops tools and collects data as indicated. d ) Uses data to drive Performance Improvement: able to ... staff and other department managers.c) Creates and sustains a culture of safety. d ) Leads and manages change effectively.e) Responds to change productively, promotes… more
- The Cigna Group (Tampa, FL)
- …Technician in the Stars Pharmacy Call Center will work within the Part D Medication Adherence area of the Cigna Medicare Stars department. The Star rating ... system was developed by the Centers for Medicare & Medicaid Services (CMS) to measure the quality...Meet service level goals (ie, call quality, daily/weekly call performance expectations, etc.). + Maintain member privacy by strictly… more
- UCLA Health (Los Angeles, CA)
- …Healthcare, or a related field required. + Five or more years of experience in a Medicare Advantage and Part D Managed Care compliance role is required. + ... processes that maintain essential elements of our compliance efforts within the Medicare Advantage program. In this role, you'll oversee policy and procedure… more
- InnovaCare (Guayama, PR)
- …members, during and after natural disasters. Through the Florida MMM Line of Care, as a Part D sponsor, you will ensure that the member has adequate access to ... Proficiency with Microsoft Office Suite19. Knowledge of CMS regulations PERFORMANCE MEASUREMENTS* Reporting functions are completed accurately and timely,...their covered Part D drugs. Orlando Family Physicians, a… more
- InnovaCare (San Juan, PR)
- …members, during and after natural disasters. Through the Florida MMM Line of Care, as a Part D sponsor, you will ensure that the member has adequate access to ... sit for extended periods of time without compromising work performance . + Customer Service Skills: practicing, valuing and supporting...their covered Part D drugs. Orlando Family Physicians, a… more
- InnovaCare (San Juan, PR)
- …members, during and after natural disasters. Through the Florida MMM Line of Care, as a Part D sponsor, you will ensure that the member has adequate access to ... benefits and serve as a primary liaison between enrolled Medicare beneficiaries and the organization in order to provide...their covered Part D drugs. Orlando Family Physicians, a… more
- InnovaCare (Guaynabo, PR)
- …members, during and after natural disasters. Through the Florida MMM Line of Care, as a Part D sponsor, you will ensure that the member has adequate access to ... sit for extended periods of time without compromising work performance .* Customer Service Skills: practicing, valuing and supporting service...their covered Part D drugs. Orlando Family Physicians, a… more
- InnovaCare (Ponce, PR)
- …members, during and after natural disasters. Through the Florida MMM Line of Care, as a Part D sponsor, you will ensure that the member has adequate access to ... with each sales rep on an ongoing basis.* Create performance review and discuss with the employees.* Answer calls...their covered Part D drugs. Orlando Family Physicians, a… more
- Prime Therapeutics (Columbus, OH)
- …information, responding to questions and resolving complex problems and issues. + If supporting Medicare Part D , will be responsible for implementing CMS ... and forecasts. + Evaluates and monitors the efficiency and performance of programs, ensuring program execution is on target....Big 4 public accounting experience. + For roles supporting Medicare Part D : Medicare… more
- Takeda Pharmaceuticals (Boston, MA)
- … Part B regional carriers, Medicare Part C managed care, Medicare Part D drug plans, all third party commercial payer, including health ... (CRM) system for market access function that includes metrics/dashboards to assess performance of Company products and team across Medicare , Medicaid, VA/DOD,… more
- State of Michigan (Lansing, MI)
- …and care coordination to people who are eligible for both Medicaid and Medicare . This position performs as a communications liaison for MDHHS assisting operational ... perform activities to assist the operational capabilities of the ICO as a Medicaid/ Medicare provider; assist in performing duties to maintain the integrity of the… more
- Commonwealth of Pennsylvania (PA)
- …in-office or on-site revisit surveys, civil rights surveys, special Centers for Medicare & Medicaid Services (CMS) surveys, and occupancy surveys using federal and ... state regulations for initial licensure, re-licensure, civil rights, and Medicare /Medicaid certification to determine compliance. You will r eview reports of… more
- AdventHealth (Tavares, FL)
- …Clinical Ladder Program* **Our promise to you:** Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in ... and has the knowledge to manage resources to achieve quality performance , positive employee relations, and compliance with hospital guidelines. The Assistant… more
- Commonwealth of Pennsylvania (PA)
- …the completion of forms/applications (such as Programs of All-Inclusive Care for the Elderly; Medicare / Medicare Part D ; Property, Tax and Rent Rebates; ... Read each question carefully. Determine and select which "Level of Performance " most closely represents your highest level of experience/training. List the… more