- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …contracting, product development, operations, financing and revenue generating programs Knowledge of Medicare Part D program, operations and industry trends ... transform healthcare? Bring your true colors to blue. The Medicare Risk Adjustment Strategy Program Manager will report to...our Company Culture page. If this sounds like something you' d like to be a part of,… more
- Optum (San Antonio, TX)
- …1+ years of experience in a customer service setting 1+ years of experience with Medicare Part D , particularly the pharmacy record review, claims, billing, ... types of prescription drug claims Working knowledge of Medicare Part B and Part D coverage guidelines and payment methodologies. Retail pharmacy… more
- Optum (San Antonio, TX)
- …1+ years of experience in a customer service setting 6+ months of experience with Medicare Part D , particularly the pharmacy record review, claims, billing ... types of prescription drug claims Working knowledge of Medicare Part B and Part D coverage guidelines and payment methodologies Previous retail pharmacy… more
- Optum (San Antonio, TX)
- …hospital 6+ months of experience with knowledge of medical terminology Knowledge of the Medicare Part D , particularly the pharmacy record review, claims, ... Provides support to internal staff, subcontractors and providers with respect to Medicare drug related issues Participates in and contributes to the overall pharmacy… more
- Novo Nordisk Inc. (Traverse City, MI)
- …treatment of diabetes, obesity, and the reduction of adverse cardiovascular events. As part of the team, you will have frontline exposure to our portfolio vision, ... who want to do the same. In exchange, we offer the chance to be part of a truly global workplace, where passion and engagement are met with opportunities for… more
- Corcept Therapeutics (Redwood City, CA)
- …ambiguity may exist Working knowledge and experience with health insurance (pharmacy benefit), Medicare Part D coverage, prior authorization processes, and ... authorizations and appeals, is required Familiarity of private payer, Medicare , and Medicaid structure, systems, and reimbursement processes is...and will not ask you to download anything as part of your interview. Though we use third-party tools… more
- Pharmacy Careers (St. Paul, MN)
- …pharmacy experience preferred. Compassionate communicator with strong organizational skills. Familiarity with Medicare Part D regulations. Why Join Us? ... Rewarding patient relationships Consistent weekday schedule Growing organization with advancement potential more
- State of Iowa (Des Moines, IA)
- …retirement payments, monthly judicial retirement state taxes and invoices for senior judges Medicare Part D and supplemental plans. This position will ... of the yearly financial statements provided to the state. This position will supervise part of the financial team. The successful candidate will be able to explain… more
- Polaris Pharmacy Services (Fort Lauderdale, FL)
- …balancing and payor verification *Verify insurance and Medicaid coverage *Handle Dual Coverage, Medicare Part D , and Commercial Plans related to Long-Term ... *Medical, Dental, Vision and Life insurance *401(k) (available to both Part -Time & Full-Time employees) *Short-term and Long-term Disability insurance *Tuition… more
- Harrow, Inc. (Los Angeles, CA)
- …understanding in the specialty of ophthalmology preferred Knowledge of payer landscape Commercial, Medicare Part D and dual eligibility Knowledge of how ... call Harrow your home and genuinely want to be part of a family and something big, then we...Harrow Family often express their pride in being a part of our commitment to (1) innovation, (2) patient… more
- Syneos Health Careers (Boston, MA)
- …information to HCP on how the products are covered under the benefit design (Commercial, Medicare Part D , Medicaid) Support patient access to the product by ... providing subject matter expertise on payer coverage issues impacting product access in a manner that complies with policies, processes and standard operating procedures Along with demonstrated initiative, resourcefulness and a results-oriented mindset, the… more
- Vertex Pharmaceuticals (Boston, MA)
- …of agreements within the US Market Access Organization (Commercial and Government (ex: Medicare Advantage and Part D )) Full Line Wholesalers, Specialty ... Distributors, Specialty Pharmacies, Group Purchasing Organizations, PBMs, and other segments and channels as required. This position will work closely with the Director, Contract Operations and cross-functional leaders to ensure agreements meet business,… more
- LanceSoft (Detroit, MI)
- …claims processing Knowledge of Privacy Regulations Pharmacy Technician Certification (PTCB) preferred Medicare Part D Experience Contact Center Experience ... This is a Hybrid role - Required to be in the office 2 times a week The pharmacy technician will assist in providing pharmacy services. Required Skills/Experience: Ability to process Coverage Determination Requests within Client Timeframes. Ability to… more
- South Shore Health (Weymouth, MA)
- …55 Fogg Road55 Fogg RoadWeymouth, MA 02190 Department Name: SSH Care Progression Status: Part time Budgeted Hours: 0 Shift: Day (United States of America) Under the ... for them the necessary clinical documentation required to help support medical necessity d - Contacts the attending physician to notify him/her of decision to issue… more
- VITAS Healthcare (Blue Bell, PA)
- …to audits and denials from third party insurance and intermediaries (ie Medicare ) Ensure that all contracted physicians (team physicians and consulting physicians) ... medical care. Ability to work collaboratively with hospice employees and volunteers as part of an interdisciplinary team. Membership in good standing on the medical… more
- South Orange County Community College District (Mission Viejo, CA)
- Location : Irvine Valley College - Irvine, CA Job Type: IVC - Faculty ( Part -Time) - Temporary Job Number: 202400368 Office, Division, or School: IVC - School of ... or as a finalist for, a position. Description Temporary, part -time faculty positions offer the opportunity to assist a...the above qualifications. If you are applying based on ( d ) above, please thoroughly and completely answer all of… more
- University of Southern California (Los Angeles, CA)
- …psychosocial needs are met. *Participates in physician and unit rounds. *Completes Medicare One Day Stay forms timely. *Completes disposition form for medicare ... safety. Please refer to the Background Screening Policy Appendix D for specific employment screen implications for the position...about access or requiring a reasonable accommodation for any part of the application or hiring process should contact… more
- Molina Healthcare (Long Beach, CA)
- …RN license in the state of MI. This position will support our MMP (Medicaid Medicare Population) that is part of the WAIVER team. This position will have ... the intranet job listing. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/ D /V. more
- Wellstar Health System (Marietta, GA)
- …clinical review cases sent for review for commercial payers, governmental, and medicare advantage plans that are referred by Care Coordination/Case Management staff ... to expedite case management issues and manage work queues. d ) Review and make suggestions regarding resource and service...to inquiries and action plans for improvement. l) As part of his/her duties, the Physician Advisor will participate… more
- City of Livermore, CA (Livermore, CA)
- …in cash to employee. BASIC LIFE INSURANCE & ACCIDENTAL DEATH & DISMEMBERMENT INSURANCE (AD & D ) FT - $60,000 EE coverage or PT - $30,000 EE coverage, ER paid $1,000 ... Comp Sick Leave Credit 4th Level 59 Survivor Ben. Military Service Credit MEDICARE (Hired after 3/31/86)EE paid 1.45%ER paid 1.45% RETIREMENT HEALTH SAVINGS (RHS) ER… more
