- Bristol-Myers Squibb Company (Princeton, NJ)
- …reporting and analysis. Responsibilities: Consolidate and maintain GTN projections for Commercial, Medicare Part D , and GPO contracted accounts Coordinate ... their personal lives. Read more: careers.bms.com/working-with-us. Summary: The Commercial & Medicare Channel Lead will manage forecasting and analytics for the… more
- VITAS Healthcare (Blue Bell, PA)
- Job Description The medical director of VITAS fulfills two primary functions, each of which is expected to consume approximately one half of the time and work effort ... of the position: The medical director has overall responsibility for medical direction of the...and denials from third party insurance and intermediaries (ie Medicare ) Ensure that all contracted physicians (team physicians and… more
- MorseLife Health Systems (West Palm Beach, FL)
- …team to include Policy and Regulatory Manager and Quality Associate *Oversee Part - D regulatory compliance as well as Medicare Fraud, Waste, and Abuse ... Job description Quality and Compliance Director is responsible for directing, evaluating, and improving...needed and Quality reporting for CMS quarterly reporting. *Integral part of the CMS/SAA Audit of the PACE program… more
- Discovery at Home (Tampa, FL)
- About Discovery At Home Discovery At Home is part of the Discovery Senior Living family of companies, a recognized industry leader for performance, innovation and ... operators. Established in 2012 with the creation of a Medicare -certified agency in Southwest Florida, Discovery At Home has...the organization offers a comprehensive range of care, including Part A services, Part B services, and… more
- CenterWell Primary Care (Morrow, GA)
- Become a part of our caring community and help us put health first Humana's Primary Care Organization is one of the largest and fastest growing value-based care, ... serve. Our care team consists of doctors, advanced practice professionals, Pharm D , Care Coach Nurse, MA, Behavioral health specialist, Quality based Coder, Referral… more
- Accuity (Sheboygan, WI)
- …for Health, Pharmacy, Dental, Vision, Disability, Life, Medicare Supplement and Medicare Part D insurance. Reconcile billings to deductions. Reconcile ... including non-qualified plans, gross ups on prizes/awards, annual W2's and director 1099's, employee compensation statements, Ward FTE and salary survey software… more
- Silverado (Austin, TX)
- Be part of a renowned team at Silverado Hospice, a Fortune Magazine Best Workplace in Aging Services (TM) , where exceptional care meets exceptional careers! For 27 ... 2-5 years of experience as a Hospice Administrator or Executive Director required. Proven leadership in supervising professional and administrative teams. Ability… more
- Discovery at Home (Tampa, FL)
- About Discovery At Home Discovery At Home is part of the Discovery Senior Living family of companies, a recognized industry leader for performance, innovation and ... operators. Established in 2012 with the creation of a Medicare -certified agency in Southwest Florida, Discovery At Home has...the organization offers a comprehensive range of care, including Part A services, Part B services, and… more
- Mount Sinai Medical Center (Hialeah, FL)
- …document(s) with other practitioners and providers *Responsible for the performance of HEDIS Part D measures (medication adherence), and SPC and CBP, CDC, MRP ... measures from Part C *Ensures patient is managed based on risk...basis with other MSMC staff as coordinated by the Director of Medicare Clinical Operations for information… more
- Rock County, WI (Janesville, WI)
- Salary: $42.44 - $46.28 Hourly Location : Janesville, WI Job Type: Part Time Job Number: RC-0804313 Department: Rock Haven Nursing Administration Opening Date: ... to ensure the appropriate delivery of care is being provided. Assists the Director of Nurses to plan, organize, develop and direct the overall operation of… more
- CVS Health (Boston, MA)
- …Key Responsibilities: + Lead the development and execution of actuarial analytics strategies for Medicare Advantage and Part D programs. + Inform and enhance ... and pricing. The ideal candidate will have deep expertise in CMS Part C and D programs, Medicare Advantage bid cycle management, and pricing strategies.… more
- Bristol Myers Squibb (Princeton, NJ)
- …reporting and analysis. **Responsibilities:** + Consolidate and maintain GTN projections for Commercial, Medicare Part D , and GPO contracted accounts + ... personal lives. Read more: careers.bms.com/working-with-us . **Summary:** The Commercial & Medicare Channel Lead will manage forecasting and analytics for the… more
- Centene Corporation (Queens, NY)
- …performance oversight for Medicare Advantage and Dual Eligible Special Needs Plans ( D -SNPs). The Manager will serve as a subject matter expert in Medicare ... position will be responsible for working with the VBP Director , other VBP Managers, and Analysts, as well as...strategic advisor on contract structure and payment methodologies for Medicare Advantage and D -SNP providers, supporting new… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …product development, operations, financing and revenue generating programs + Knowledge of Medicare Part D program, operations and industry trends ... The Medicare Risk Adjustment Strategy Program Manager will report to the Senior Director of Medicare Risk Adjustment and Analytics. This role will manage the… more
- Central Maine Medical Center (Lewiston, ME)
- …and for each other every day. Position Summary: Reporting to the Nursing Director , the Nurse Leader is responsible for the day-to-day operations of assigned ... evaluating the operation of their assigned department. In conjunction with the Director , the Nurse Leader is responsible for overseeing implementation of patient… more
- Molina Healthcare (Boise, ID)
- …and internal policies and procedures. * Supports the Operational Oversight Manager, Director , and team in the general development of the Operational Oversight ... to demonstrate compliance to regulatory requirements. * Supports Manager and Director with developing the Operational Oversight Work Plan, monitoring and reporting… more
- Cambridge Health Alliance (Cambridge, MA)
- …PACE and HPO. * Lead internal and external audit preparation and response, including Medicare Part D and Enrollment Data Verification. * Develop and ... Director , Health Plan Operations - PACE Elder Service...participants. This role is responsible for overseeing Medicaid and Medicare enrollment, claims, reporting, risk adjustment, compliance, contract management,… more
- Amneal Pharmaceuticals (Bridgewater, NJ)
- …to our current Market Access landscape (ie IRA and its impact on Amneal products for Medicare Part D ). Manage to a market access budget throughout the year, ... Description: The Senior Director of Market Access Strategy is responsible for...Pharmacy benefit formularies, across all lines of business (Commercial, Medicare , & Managed Medicaid), as well as monitoring and… more
- Trinity Health (Gaithersburg, MD)
- …of Directors. + Ensure compliance with CMS regulations. Has overall responsibility for the Medicare Part D fraud, waste and abuse Compliance Program. Assure ... **Employment Type:** Full time **Shift:** Day Shift **Description:** ** Director , Quality, Improvement and Compliance** **Location:** Trinity Health PACE of… more
- WelbeHealth (Los Angeles, CA)
- …financial modeling tools + Deep understanding of CMS risk adjustment, Medicaid rate-setting, and Medicare Advantage/ Part D payment models + Must be willing ... seniors with better quality and compassion in a value-based model. The Director , Actuary is accountable for all actuarial functions related to PACE revenue,… more
