- CVS Health (Hartford, CT)
- …we do it all with heart, each and every day. **Position Summary** The Divisional CFO for Medicare Part D and Medicare Supplement is responsible for the ... **Strategic Finance & Leadership** + Serve as the chief financial partner to the Medicare Part D and Medicare Supplement business leadership teams. +… more
- US Tech Solutions (May, OK)
- …06+ months contract **Note:** + Ideal candidates must have experience of Prior Authorization, Medicare Part D and Pharmacy Benefit Management experience. + ... **Job Description:** + As a Pharmacist Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy… more
- Prime Therapeutics (Salem, OR)
- …cost effective delivery of service; design, develop, and implement annual operating budget and the Medicare Part D annual bid + Partner with stakeholders and ... healthcare industry and recognition for government program expertise; strong understanding of Medicare Part C and D rules and regulations + Exceptional… more
- Corewell Health (Grand Rapids, MI)
- …adherence + Educate members on disease state and medication + Educate members on Medicare Part D benefits and drug coverage to increase understanding ... Pharmacy Intern, under the direct supervision of a licensed Medicare Quality pharmacist, will engage with Medicare ...licensed Medicare Quality pharmacist, will engage with Medicare members to improve medication adherence to Medicare… more
- CVS Health (Hartford, CT)
- …and member/nonparticipating providers). * Provide direct support to appeal nurses and dedicated Medicare part D pharmacists; supervision and participation in ... **Responsibilities of this Medical Director role are related to Medicare Appeals:** * Direct daily work on part...Management Strategy support * Develop subject matter expertise on Medicare policy for the enterprise * Provide ongoing education… more
- US Tech Solutions (May, OK)
- …HAVE 6 months of experienced with Prior Authorization(required). + MUST HAVE experience with Medicare Part D + Must Have Pharmacy Benefit Management (PBM) ... experience. **Education:** + Pharm D . required with at least two years' experience as a pharmacist in Managed care environment. + Must have an active license in the… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …members Education and Experience: + Minimum 2-3 years of customer/member service experience + Medicare Part D and/or Pharmacy experience preferred + BS/BA or ... by visiting our Company Culture (https://careers.bluecrossma.org/us/en/culturepage) page. If this sounds like something you' d like to be a part of, we' d love… more
- Rhythm Pharmaceuticals (Boston, MA)
- …appropriate access and coverage for Rhythm's portfolio across key commercial self-insured employers and Medicare Part D payers. The Senior NAD will develop ... of payer engagement and strategic account management in the commercial self-insured and/or Medicare Part D channels. The position reports into the VP, Market… more
- Humana (Lincoln, NE)
- …Policies and Procedures, and clinical literature as appropriate. Medical Directors will learn Medicare Part D and Medicare Advantage requirements ... first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ( Part D & B). The Medical director work assignments involve… 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 ... by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines,… more
- US Tech Solutions (AZ)
- …months contract** **Job Description:** + As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to ... by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines,… more
- US Tech Solutions (May, OK)
- …availability could be required. **Experience:** + Prior authorization experience preferred. + Medicare Part D experience required + Previous pharmacy ... of experience although 2-5 years is preferred. **Skills:** + Prior Authorization + Medicare Part D **Education:** + Bachelor's Degree Required, Pharm D … more
- Centene Corporation (Tallahassee, FL)
- …helping to create the new call flows/tools. **Desired skills:** + **Pharmacy** : Understanding Medicare Part D , particularly PDP is a plus. + **Technical ... analysis on a variety of complaints that come from Medicare directly to identify trends and opportunities for process...and marketing issues. + The PDP Specialist will be part of PDP SWAT team. The ultimate goal of… more
- WTW (Philadelphia, PA)
- …in individual health products, such as Medicare Advantage, Medicare Supplement, Medicare Part D and other individual health and ancillary plans. The ... preferred candidate may also have knowledge of ERISA, state insurance laws, Medicare , and/or experience in the employee benefits or health insurance industries. The… more
- Molina Healthcare (Ann Arbor, MI)
- …& legal processes (Commercial insurance, Medicare , Medicare Advantage, Medicare Part D , Medicaid, Tricare, Pharmacy, etc.) + Experience ... oral and written communication skills and presentation skills. + Medicare and Marketplace experience **JOB QUALIFICATIONS** **Required Education** High School… more
- Trinity Health (Gaithersburg, MD)
- …and correct CMS return files, RAPS, and encounter data. + Ensure compliance with Medicare Part D reporting requirements and prepare annual bid submissions. ... Health PACE (TH PACE) programs. This role manages revenue cycles for Medicare , Medicaid, and private pay, oversees expense cycles including vendors and medical… more
- CVS Health (Harrisburg, PA)
- …for internal and external stakeholders. + Become a subject matter expert on select Medicare Part D Star measures. **Ideal Candidate Profile:** + Strong ... Medicare Product** to support the development, launch, and optimization of our Medicare Part - D product suite. This role is ideal for a strategic thinker… more
- US Tech Solutions (RI)
- …exception requests for multiple clients or lines of business and in accordance with Medicare Part D CMS Regulations. + Must apply information provided ... where needed. **Responsibilities:** + Utilizing multiple software systems to complete Medicare appeals case reviews + Meeting or exceeding government mandated… more
- US Tech Solutions (May, OK)
- …exception requests for multiple clients or lines of business and in accordance with Medicare Part D CMS Regulations. Must apply information provided through ... where needed. **Responsibilities:** + Utilizing multiple software systems to complete Medicare appeals case reviews + Meeting or exceeding government mandated… more
- Commonwealth of Pennsylvania (PA)
- …eligibility for benefits, and assisting with the completion of forms/applications (such as PACE/PACENet, Medicare / Medicare Part D , Property, Tax & Rent ... included assisting them with the completion of forms/applications. + D . I have NO experience related to this work...OF COMPUTER SYSTEMS for my electronic case documentation. + D . I have NO experience related to this work… more