- The Cigna Group (Bloomfield, CT)
- **Legal Compliance Advisor - Medicare Part D / Rx Service Operations ** _Medication Therapy Management (MTM), Formulary, Drug Utilization Review (DUR), ... Abuse (FWA,) and Clinical Decision Making_ **Role Summary** The Medicare Part D Legal Compliance...Compliance Advisor is responsible for compliance support of service operations with specific focus on Medicare clinical… more
- Centene Corporation (Raleigh, NC)
- …Pharmacy Service Center, Medicare Part D / Part B, Appeals, Medicare Part D Operations and State Health Programs Pharmacy Operations or ... material. + Responsible for knowing and interpreting pharmacy and medical benefits. + Medicare Part D Operations + Reviews and processes PDE files… more
- Medical Mutual of Ohio (OH)
- …supervision, administers standardized to moderately complex daily operations in compliance with the Medicare Part D (pharmacy) and Medicare Part ... administers standardized to moderately complex daily operations in compliance with the Medicare Part D (pharmacy) and Medicare Part C (medical… more
- CVS Health (Honolulu, HI)
- …affordable. Position Summary As a Rep II, Operations , you will be directly supporting Medicare Part D & B members and providers with requests related to ... information and completing timely and accurate documentation of all Medicare Part D & B...some holidays may be required. As a Rep II, Operations , you'll show a high level of attention to… more
- CVS Health (Hartford, CT)
- …Must be able to understand data sets and identify technological efficiencies within Medicare Part D bid development and submission processing. Position ... D subject matter expert supporting end to end Part D Product operations efforts...including bids, implementation, benefits, reporting and analysis. 2-3 Years Medicare Part D Experience; 1-2… more
- UCLA Health (Los Angeles, CA)
- …of member accounts, and issuance of invoices. This position requires a deep understanding of Medicare Part D programs and meticulous attention to detail to ... Description As a member of the Medicare Advantage Operations team, the ...and billing regulatory requirements * In depth knowledge of Medicare Part D programs and… more
- UCLA Health (Los Angeles, CA)
- …enrollment, disenrollment, and cancellation requests. This position requires a deep understanding of Medicare Part D programs and meticulous attention to ... Description As a member of the Medicare Advantage Operations team, the Senior...workgroups and other meetings * Ability to work as part of a team, collaborating with colleagues * Ability… more
- CVS Health (Hartford, CT)
- …all types of pharmacy products including specialty drug, Medicare Part D and understanding of PBM operations + Working knowledge of Microsoft Office ... reprioritizing as needed + Knowledge of all types of health care products including HMO, PPO, Medicare Advantage and Medicare Part D + Knowledge of… more
- City of New York (New York, NY)
- … Medicare 's preventive services. New York State certified counselors provide assistance with Medicare Part D prescription plan selection, Medicare ... (HIICAP) helps older adults navigate the complexities of all components of Medicare . HIICAP conducts public outreach presentations and workshops to older adults,… more
- BlueCross BlueShield of North Carolina (NC)
- … pharmacy program across Medicare Advantage, including DSNP. EGWP and the Medicare Prescription Drug Program ( Part D ) to include operational expense, ... Medicare Advantage, including DSNP, EGWP and the Medicare Prescription Drug Program ( Part D...to share and gain insights in all areas of Medicare work ( operations , quality, cost of care);… more
- Catholic Health Initiatives (Lexington, KY)
- …Knowledge, Skills, Abilities and Training** + Knowledge of Medicaid, Medicare Advantage plans, Medicare Part D + Knowledge of hospital revenue cycle. + ... in the community. **Responsibilities** **Job Summary / Purpose** The Pharmacy Operations Specialist is responsible for CHI Saint Joseph Health System's Medication… more
- Catholic Health Initiatives (Lexington, KY)
- …Knowledge, Skills, Abilities and Training** + Knowledge of Medicaid, Medicare Advantage plans, Medicare Part D + Knowledge of hospital revenue cycle. + ... **Responsibilities** **Job Summary / Purpose** The Patient Assistance Coordinator/Pharmacy Operations Specialist is responsible for CHI Saint Joseph Health System's… more
- Bristol Myers Squibb (Madison, NJ)
- …partners about reimbursement/access landscape (ie, coding, reimbursement and payer polices related to Medicare , Medicare Part D , Medicaid, and Private ... Read more: careers.bms.com/working-with-us . **Summary:** The Senior Manager of Access Support Program Operations & Above Brand Strategy will play a key role in the… more
- Commonwealth of Pennsylvania (PA)
- …ST04 Bureau / Division Code 00211771 Bureau / Division Bureau of Financial Operations /Division of Financial Policy and Operations Worksite Address Warren State ... to utilize your analytical skills? The Bureau of Financial Operations is seeking an energetic, detail-oriented individual to be...processing of accounts, as well as the processing of Medicare billing. You will also verify Medicare … more
- AdventHealth (Tavares, FL)
- …- 20k sign on bonus **Our promise to you:** Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in the ... professional nurse who supports the Nurse Manager in overall operations of their assigned unit. Is able to demonstrate...competency in care delivery. Develops staff preceptors and mentors. d . Assures diversity of staff is positively fostered in… more
- AdventHealth (Winter Haven, FL)
- …for the NCLEX* **Our promise to you:** Joining AdventHealth is about being part of something bigger. It's about belonging to a community that believes in ... the community for over 50 years. - As a part of the AdventHealth network patients will have greater...who supports the Nurse Manager or Director in overall operations of their assigned unit.** **Is able to demonstrate… more
- American Institutes for Research (MA)
- …experience with federal agencies, including but not limited to the Centers for Medicare and Medicaid Services (CMS). Candidates hired for the position may work ... goes beyond legal compliance to its full integration in our strategy, operations , and work environment. At AIR, we define diversity broadly, considering everyone's… more
- Mitsubishi Chemical Group (Jersey City, NJ)
- …be responsible for strategic imperatives and tactical planning for targeted government channels: CMS, Medicare Part B MAC's, VA, DOD and Tricare East and West. ... (ALS), and Parkinson's (PD). MTPA is rapidly expanding its operations across all functional areas. MTPA's commitment to patients...and experience in different access and reimbursement models, including Medicare Parts B and D , Medicare… more
- VIP Care (Tampa, FL)
- …and cost performance. Meet at least monthly assigned PCPs + Review drivers of off-track Part A, B, and D utilization with PCPs running higher than benchmark ... target populations Additional Eligibility and Qualifications: + Experience with Clinical Operations and Medicare + Understanding of Healthcare Best Practices… more
- CareFirst (Baltimore, MD)
- …activities. + Experience with developing and implementing clinical programs. + Experience with Medicare Part D and Medicaid guidelines and requirements. + ... implementing the organization's pharmacy vision and strategic plan for government programs ( Medicare and Medicaid). This role has oversight of pharmacy staff and… more