- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …and its related financial models, including Medicare FFS, Medicare Advantage, Medicare Part D , and Medicare supplemental coverage. Advanced ... BCBSMA, with a focus on senior product strategy and Medicare Markets. This candidate must be a creative thinker...our Company Culture page. If this sounds like something you' d like to be a part of,… more
- Syneos Health Careers (Nashville, TN)
- …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 ... are required to submit proof of vaccination to Syneos Health and maintain compliance with these requirements. At Syneos Health, we believe in providing an… 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 ... to improve care. *Adheres to TENET policies and procedures. *Identifies compliance and ethical issues and reports appropriately. Patient Advocacy *Respects… more
- UnitedHealth Group (Waterbury, CT)
- …the provider/team with benefit determination associated with Medicare part A, part B, and part D benefits Responsible for collaborating with the ... Sign on Bonus being offered to external candidates Optum Home & Community Care, part of the UnitedHealth Group family of businesses, is creating something new in… more
- University of Southern California (Arcadia, CA)
- …outcomes, customer satisfaction and a positive work environment. Participate in maintaining compliance with the Joint Commission (TJC) and Center 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
- MASS (Worcester, MA)
- …completes supportive and protective device forms Communicates with pharmacist to provide and ensure Medicare Part D insurance plans are in place. Responsible ... by the RN Managers and State Operations Directors. As part of daily assignments, the incumbent will be required...for individuals to ensure appropriate medical care is in compliance with human rights Schedules and may attend medical… more
- Stop & Shop (Winsted, CT)
- …& Shop is a place where everyone can thrive and feel like they're part of family. Our more than 50,000 associates enjoy competitive salaries, comprehensive benefits ... appropriately. Maintain organized records and files (prescriptions, daily logs, Medicare records, orders, schedules, recall notices, personnel/staff paperwork and… more
- County of San Bernardino, CA (San Bernardino, CA)
- …Date To: (MM/DD/YYYY) (when you performed these duties) d )Your Role: professional level administrative/analytical experience with primary responsibility ... Developing, negotiating, and interpreting contract terms and agreements; and monitoring compliance and/or performance. If you do not have such experience, indicate… more
- Home Services Unlimited (Indianapolis, IN)
- …Summary Home Services Unlimited is one of Indy's most established independent Medicare -certified agencies. We are seeking an experienced home health nurse to serve ... providers. We currently are seeking a Full-Time RN Case Manager (or Part -time) to perform assessments, provide direct nursing care and develop, implement and… more
- DHR Health (Edinburg, TX)
- …of cytotechnology or certified by certification agency approved by The Centers for Medicare & Medicaid Services (CMS) required or an Associates with one year ... section. Ensure the department policies and procedures are in compliance with regulatory agencies, eg Joint Commission, College of...who performs these duties are not called upon as part of their employment to perform or assist in… more
- Kaiser Permanente (Ontario, CA)
- …and appropriate resource use. Recommends alternative levels of care and ensures compliance with federal, state and local requirements. Assesses high risk patients in ... Adheres to internal and external regulatory and accreditation requirements and compliance guidelines including but not limited to: TJC, DHS, HCFA, CMS,… more
- ATC Athens (Fayetteville, GA)
- …and patient progress accurately and timely in electronic medical records. Maintain compliance with state regulations, Medicare guidelines, and agency policies ... experience in psychiatric care, work flexible contracts, and be part of a trusted team dedicated to supporting vulnerable...national origin, veteran or disability status or any other category protected by Federal, State or local law. M/F/ D /V… more
- US Tech Solutions (May, OK)
- …by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, ... **Job Description:** + As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy… more
- US Tech Solutions (AZ)
- …by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, ... **Job Description:** + As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy… more
- The Cigna Group (Bloomfield, CT)
- …is designed to provide a designated full time support to Express-Script's external client's Medicare Part D business. This role will matrix with internal ... role will assist in development of actuarial analyses for Medicare Part D business, including...Bid Development, Desk Review & Audits + CMS Regulatory Compliance / Reporting + Financial Reconciliation Modeling + Trend… more
- Prime Therapeutics (Oklahoma City, OK)
- …fuels our passion and drives every decision we make. **Job Posting Title** Mgr Medicare Part D Pharmacy Programs - Remote, Pennsylvania **Job Description** ... the coordination of benefits in the pharmacy program with Medicare Part D plans. Provides...and leadership skills that ensure successful Part D pharmacy operations and program compliance within… more
- CVS Health (Hartford, CT)
- …and Aetna's exciting and growing government services pharmacy business. The primary focus is the Medicare Part D product strategy and pricing of MAPD, SNP ... and PDP Products. This role will focus on developing health care solutions for Medicare Part D members. The colleague provides actuarial support to ensure… more
- CVS Health (Hartford, CT)
- …do it all with heart, each and every day. Position Summary: The AVP, Actuary - Medicare Part D is responsible for analyzing and forecasting the financial ... internal and external cross-functional business issues. Preferred Qualifications: + Pharmacy and Medicare Part D experience strongly preferred Education: +… more
- Trinity Health (Gaithersburg, MD)
- … with CMS regulations. Has overall responsibility for the Medicare Part D fraud, waste and abuse Compliance Program. Assure annual review and approval of ... time **Shift:** Day Shift **Description:** **Director, Quality, Improvement and Compliance ** **Location:** Trinity Health PACE of Montgomery County, Gaithersburg, MD… more
- 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 ... The ideal candidate will have deep expertise in CMS Part C and D programs, Medicare...end-to-end bid cycle process, including pricing, forecasting, and regulatory compliance . + Serve as a subject matter expert on… more
