- Lundbeck (Atlanta, GA)
- …anticipate and effectively address payer access issues (IDNs, Medicare , Medicaid, Commercial) using Lundbeck resources. Pharmaceutical Environment/Compliance - ... Apply knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of pharmaceutical and medical products. REQUIRED EDUCATION, EXPERIENCE and… more
- Lundbeck (Miami, FL)
- …anticipate and effectively address payer access issues (IDNs, Medicare , Medicaid, Commercial) using Lundbeck resources. Pharmaceutical Environment/Compliance - ... Ability to apply knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of pharmaceutical and medical products. REQUIRED EDUCATION,… more
- Eisai, Inc (Miami, FL)
- …the US healthcare system across one or more major payer segments ( Medicare , Medicaid, Federal, and Commercial).Experience working with medical and pharmacy benefits, ... coverage policies, and reimbursement.Proven performance in earlier role.As a condition of employment and an essential function of this field-based position, applicants must be able to engage in person with HCPs and other third parties at their offices,… more
- Novo Nordisk Inc. (WA)
- …may include, but are not limited to: NN Foundation, Quality, Medicare , Medicaid, Transparency, Adherence, Importation, Reference Pricing, Pricing / Price Increases, ... Stem-Cell, Research, NIH, Reimbursement, IP, Labor / Employment, Tax, Trade, Privacy, Data Transparency Proactively explore and evaluate potential/emerging policy proposals Build and maintain strategic networks of relationships internally (locally and… more
- Lundbeck (Fort Wayne, IN)
- …internal and external partners and effectively addresses payer access issues ( Medicare , Medicaid, Commercial) using Lundbeck resources. Local Market & Therapeutic ... Area Expertise - Gather and validate key trends and dynamics in the market, map account linkages, and apply comprehensive therapeutic knowledge to uncover and prioritize unique opportunities. Demonstrates a clear and detailed understanding of the disease state… more
- Molina Healthcare (New York, NY)
- …and production of the annual marketing strategy and objectives for Molina Medicare 's portfolio of Medicare products. + Responsible for supporting the ... + Developing, implementing, improving, and maintaining Marketing Operations for Molina Medicare . + Directing and analyzing Market Research Activities for Molina … more
- Molina Healthcare (Grand Island, NE)
- **Job Description** **Job Summary** Leads and directs Molina Medicare segment leaders who are responsible for the development and administration of Medicare ... markets, including D-SNP market performance management. + Function as Medicare subject matter expert and point of contact for...regulatory items + Under the leadership of the VP Medicare Segment Lead, this role will facilitate transparent and… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …exposure to all areas of BCBSMA, with a focus on senior product strategy and Medicare Markets. This candidate must be a creative thinker with the ability to drive ... collaboratively with both technical and non-technical staff including Underwriting, Medicare Product Development, Provider Contracting, Sales, and others across the… more
- The Cigna Group (Bloomfield, CT)
- …position will provide external actuarial analytics support within the regulated Medicare market and Pharmacy Benefit Manager (PBM) Healthplan space. This actuarial ... a designated full time support to Express-Script's external client's Medicare Part D business. This role will matrix with...role will assist in development of actuarial analyses for Medicare Part D business, including but not limited to;… more
- Centers Plan for Healthy Living (Staten Island, NY)
- …with the guidance and plans they need for healthy living. JOB SUMMARY : The Medicare MAP Advisor- Will promote and sale MAP and Medicare Line of Business, ... in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and...Medicaid Services (CMS) and company policies and regulations. The Medicare MAP advisor will develop a presence in the… more
- Wider Circle (Los Angeles, CA)
- …a fast-growing boutique insurance agency focused on helping people understand their Medicare Benefits. We work with underserved populations to help them navigate ... Medicare to identify the best benefits for their needs....Specialist to join our fast-paced team to connect with Medicare beneficiaries and help them schedule appointments with our… 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 benefits. ... information when needed, and ensuring accurate decisions that comply with compendia and Medicare guidance and timelines. This is a great opportunity to initiate a… more
- Molina Healthcare (Kenosha, WI)
- Molina Healthcare is hiring for its outbound Medicare Member Engagement team. Candidates who are Bilingual in either Mandarin or Cantonese are highly desired. This ... and will work 8am to 430pm Pacific Standard Time, Monday through Friday. Medicare Member Engagement Specialists will make outbound welcome calls to our members along… more
- PruittHealth (Norcross, GA)
- …PURPOSE:** Compilation and verification of required third party documentation for all Medicare bad debt claims on an annual cost reporting basis. Calculation of ... allowable Medicare bad debt claims based on third party documentation...2. Validate and document each paid, adjusted, and/or denied Medicare Part A coinsurance crossover claim on each remittance… more
- Wider Circle (Los Angeles, CA)
- …a fast-growing boutique insurance agency focused on helping people understand their Medicare Benefits. We work with underserved populations to help them navigate ... Medicare to identify the best benefits for their individual...embracing boundless personal and collective growth opportunities. Responsibilities for Medicare Sales Representative * Primarily be responsible for the… more
- Community Health Systems (La Follette, TN)
- **Job Summary** The Medicare Billing Specialist is responsible for performing timely and accurate Medicare billing activities, including claims preparation, ... submitted in accordance with regulatory guidelines and organizational policies. The Medicare Billing Specialist supports compliance with federal and state billing… more
- Molina Healthcare (Boston, MA)
- …for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare -Medicaid recipients within approved ... product features and differences. + Enroll eligible individuals in Molina Medicare products accurately and thoroughly complete and submit required enrollment… more
- State of Indiana (Indianapolis, IN)
- Medicaid/ Medicare Coordination Manager Date Posted: Sep 5, 2025 Requisition ID: 464717 Location: Indianapolis, IN, US, 46204 Work for Indiana Begin a fulfilling ... is fully engaged with this mission. Role Overview: In this role, Medicaid/ Medicare Coordination Manager, you will establish priorities, targets, and deadlines for… more
- Commonwealth Care Alliance (Boston, MA)
- …This role will ensure that the applicable edits are compliant with applicable Medicare and Massachusetts Medicaid regulations. The role will also be responsible for ... as necessary on all new and revised coding logic, related Medicare /Medicaid policies for review/approval through the Payment Integrity governance process.… more
- Molina Healthcare (Green Bay, WI)
- …for increasing membership through direct sales and marketing of Molina Medicare products to dual eligible, Medicare -Medicaid recipients within approved ... product features and differences. + Enroll eligible individuals in Molina Medicare products accurately and thoroughly complete and submit required enrollment… more
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