- Prime Therapeutics (Oklahoma City, OK)
- …that. It fuels our passion and drives every decision we make. **Job Posting Title** Mgr Medicare Part D Pharmacy Programs - Remote, Pennsylvania **Job ... Manages the coordination of benefits in the pharmacy program with Medicare Part D plans. Provides the technical and leadership skills that ensure… more
- The Cigna Group (Bloomfield, CT)
- … D bid development consulting experience preferred + Regulated Markets Medicare Part D Experience Pharmacy Benefit Manager (PBM) / Healthcare / ... will provide external actuarial analytics support within the regulated Medicare market and Pharmacy Benefit Manager (PBM)...a designated full time support to Express-Script's external client's Medicare Part D business. This… more
- Walgreens (Deerfield, IL)
- **Job Description:** **Job Summary:** Responsible for managing the finances for the Medicare Part D Pharmacy contracts with PBMs and insurance companies. ... This role will help create relevant Power BI dashboards to help summarize Medicare Part D reimbursement performance. **Job Responsibilities:** + Develops… more
- CVS Health (Hartford, CT)
- …exciting and growing government services pharmacy business. The primary focus is the Medicare Part D product strategy and pricing of MAPD, SNP and ... skills and attention to detail Preferred Qualifications + Previous Pharmacy or Medicare Part D experience + FSA designation + Experience with SAS, SQL,… more
- US Tech Solutions (May, OK)
- …of experienced with Prior Authorization(required). + MUST HAVE experience with Medicare Part D + Must Have Pharmacy Benefit Management (PBM) experience. ... knowledge of drug and disease states for the Specialty and Non-Specialty Pharmacy programs administered within the Medicaid, Commercial Prior Authorization and Case… more
- US Tech Solutions (May, OK)
- …of experienced with Prior Authorization(required). + MUST HAVE experience with Medicare Part D + Must Have Pharmacy Benefit Management (PBM) experience. ... knowledge of drug and disease states for the Specialty and Non-Specialty Pharmacy programs administered within the Commercial Prior Authorization and Case Review… more
- US Tech Solutions (May, OK)
- …of experienced with Prior Authorization(required). + MUST HAVE experience with Medicare Part D + Must Have Pharmacy Benefit Management (PBM) experience. ... and procedure. **Experience:** + Prior authorization experience required. + Previous pharmacy experience in retail or hospital preferred. + Appropriate state license… more
- US Tech Solutions (May, OK)
- …**Experience:** + Prior authorization experience preferred. + Medicare Part D experience required + Previous pharmacy experience in retail or hospital ... technical knowledge of drug and disease-states for the Specialty Pharmacy programs administered within the Case Review Unit. +...2-5 years is preferred. **Skills:** + Prior Authorization + Medicare Part D **Education:** +… 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
- Ascension Health (Nashville, TN)
- …adjudication, including troubleshooting and prior authorization processing. + Strong understanding of Medicare Part D and medication adherence quality ... **Details** + **Department:** Virtual Pharmacy + **Schedule:** Monday - Friday, 8 am...documentation and communication. + Assist in tracking and improving Part D adherence metrics (eg, PDC for… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …formulary exceptions and prior authorizations according to the Medicare Part D defined guidelines + Work with the Pharmacy Benefit Manager (PBM) and ... Plan's Medicare Prescription Drug Program, including compliance and oversight of Medicare Part D laws, regulations and reporting requirements, benefit… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …activities to ensure that all Commercial ( Pharmacy and Medical benefits) and Medicare Advantage Part D coverage determination requests are processed ... transform healthcare? Bring your true colors to blue. The Pharmacy Operations Clinical Pharmacist Manager manages and directs clinical...in the development, communication and implementation of Commercial and Medicare Part D formulary and… more
- Apex Health Solutions (Houston, TX)
- …technicians) in all aspects of pharmacy operations and services including Medicare part D oversight, coverage determination and re-determination (appeal) ... health experience or other work experience in an equivalent background such as Medicare Part D program. Certificates and Licenses: Current, unrestricted… more
- Elevance Health (Indianapolis, IN)
- …complex pharmacy data to identify cost drivers and trend patterns within the Medicare Part D Individual and Group markets + Identifies and evaluates ... data related to Pharmacy cost of care, pharmacy trends, and other Medicare book of...analytical, organizational, presentation, and problem solving skills preferred. + Medicare Part D experience is… more
- CVS Health (Austin, TX)
- …Microsoft Office suite; proficiency in Excel. Preferred Qualifications + Prior Pharmacy or Medicare Part D experience. + Experience with SQL, SAS, and/or ... actuarial team supporting CVS Health and Aetna's Government Services Medicare Advantage and Prescription Drug Plan business. This position...+ Apply quantitative skills and analytical methods to support Part D business needs. + Foster strong… more
- Amazon (Boston, MA)
- …PBM, health insurance, pharmacy , business development, marketing, managed care, Medicaid, Medicare Part D , and commercial innovation. - Bachelor's degree ... Pharmacy About the team Payer relations business development is part of Amazon Pharmacy Partener Services, representing Amazon pharmacy with key… more
- Sharp HealthCare (San Diego, CA)
- …include validating accuracy, completeness and timeliness for all commercial and Medicare pharmacy processes, processing prior authorization review including ... pharmacy practice, trade/generic drug names, drug pricing interpretation, metric system, CMS Part D requirements and CMS RXCUI nomenclature, state and federal… more
- GEHA (Lee's Summit, MO)
- …+ Excellent vendor management and negotiation skills + Strong knowledge of federal and state pharmacy regulations, CMS Part D , EGWP, and FEHB requirements + ... experience, sustained by a nimble and efficient organization. The Vice President, Pharmacy is a senior executive leader responsible for setting and executing GEHA's… more
- Sharp HealthCare (San Diego, CA)
- …-REQUIRED **Preferred Qualifications** + 3 Years experience with managed care, PBM and/or Medicare Part D , Medicaid, Commercial Health Insurance. + ... **Shift End Time** California Pharmacist License - CA State Board of Pharmacy **Hours** **:** **Shift Start Time:** Variable **Shift End Time:** Variable **AWS… more
- AdventHealth (Bolingbrook, IL)
- …controlled substance oversight, and billing including, Long Term Care (LTC) billing and Medicare D claim adjudication. + Serves as a resource for automation ... Resources and Support **Our promise to you:** Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in… more