- 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
- 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
- Humana (Honolulu, HI)
- …our pharmacy business. This leader will need deep understanding of the complexities of Medicare Part D benefit design and regulatory changes to develop ... experienced and strategic leader to fill the position of Director of Internal Pharmacy Forecasting and Performance Analytics. This...pharmacy trends, taking into account regulatory changes in the Medicare Part D space +… 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
- The Cigna Group (St. Louis, MO)
- …of Regulated Markets is responsible for Coverage Review and Determinations for Medicare Part B and Part D , Medicaid, Marketplace or Healthcare Reform ... **Job Description: Director for Regulated Markets - CDAG/ODAG** **Excited to...of technical requirements to ensure ongoing compliance, Center for Medicare and Medicaid (CMS) Audit support and end-to-end ownership… more
- Bristol Myers Squibb (Washington, DC)
- …role will lead our efforts in existing and future expected negotiations for products that span Medicare Parts D and B. The role will also be a key SME advisor ... lives. Read more: careers.bms.com/working-with-us . **Summary:** We are currently seeking a Director , IRA Project Management to join the US Pricing, Analytics and… more
- Teva Pharmaceuticals (Parsippany, NJ)
- …points into clear, actionable contract language + Deep experience within Commercial GPO/PBM/MBMs, Medicare Part D /B and Medicaid contracting channels + ... Director , Managed Care Payer Contracting (V&A) Date: Jul...people to make a difference with. **The opportunity** The Director , Managed Care Payer Contracting is a key leadership… more
- Prime Therapeutics (Richmond, VA)
- …variety of constituents **Preferred Qualifications** + Integrated health system or health plan experience + Medicare Part D and B experience + Call center or ... and drives every decision we make. **Job Posting Title** Director of Service Delivery **Job Description** The Director...a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources… more
- Sanofi Group (Morristown, NJ)
- …conducting analytics for select regional accounts. + Oversee development and negotiation of Medicare Part D , Managed Medicaid, and Commercial GPO/PBM ... **Job Title** : Director Market Access Contracting **Location** : Morristown, NJ...diseases and blood disorders, cancers, and neurological disorders. From R& D to sales, our talented teams work together, revolutionizing… more
- Takeda Pharmaceuticals (Boston, MA)
- …including HTA trends and guidance (eg, NICE, CADTH, PBAC, EU JCA) along with knowledge of US Medicare ( Part D ), ICER in the US and trends in Emerging Markets ... LOC level Decision-making and Autonomy + Responsibility in line with Associate Director level position; independently lead HE projects and support the Global Health… more
- AbbVie (Mettawa, IL)
- …dynamics that drive profitability + Support all channels of payer contracting including Commercial, Medicare Part D , Medicaid and other Government channels + ... We are smart, fun, quirky, and innovative - and we' d love for you to join us. The individual...to join us. The individual hired as the Associate Director , Payer Contract Analytics, within the Market Analytics and… more
- Bristol Myers Squibb (Tampa, FL)
- …leadership of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D rebate processing and payments, data stewardship and ... you require reasonable accommodations/adjustments in completing this application, or in any part of the recruitment process, direct your inquiries to ###@bms.com .… more
- Bristol Myers Squibb (Princeton, NJ)
- …leadership of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D rebate processing and payments, data stewardship and ... you require reasonable accommodations/adjustments in completing this application, or in any part of the recruitment process, direct your inquiries to ###@bms.com .… more
- BrightSpring Health Services (Louisville, KY)
- …PBM and 3rdParty Payor contracting process for LTC PharMerica business unit. This includes Medicare Part D , Commercial and Managed Medicaid. + Manage and ... negotiate national 3rdParty Payor and PBM contracts to ensure company's objectives are met in a timely manner. + Develops and executes a dynamic and strategic PBM and Payor strategy to support annual plan and business objectives. This includes effectively… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …Plan's Medicare Prescription Drug Program, including compliance and oversight of Medicare Part D laws, regulations and reporting requirements, benefit ... with other constituents, including but not limited to: Pharmacy Director , Chief Medical Officer, Medical Director , Pharmacy...for formulary exceptions and prior authorizations according to the Medicare Part D defined guidelines… more
- BAYADA Home Health Care (Orlando, FL)
- **Please note- Candidates must have COS-C, HCS-O or COQS and HCS- D or BCHH-C in order to be considered, there is no flexibility around this requirement.** BAYADA ... Manager provides support to all BAYADA Home Health Care Medicare service offices by monitoring Outcome and Assessment Information...productivity maintained at the quarterly target set by the Director of MCM. + Prevent or decrease the occasion… more