- 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
- Thrifty White Pharmacy (West Fargo, ND)
- … B requirements Troubleshoots any rejected claims or billing issues. Assists customers with Medicare Part D questions. Maintains proper level of nursing home ... ND Pharmacy Tech-in-Training - FT #046 West Fargo, North Dakota Thrifty White Pharmacy is seeking out a Pharmacy Technician-in-Training in #046 West Fargo,… more
- Walgreens (Miami, FL)
- …able to address/understand/discuss complex reimbursement systems and flow of the healthcare dollar ( Medicare Part B/ D , ACOs, GPOs, Hospitals, etc.). Job ... segments. In addition, experience with billing procedures for hospital, medical offices and Medicare (B / D benefits). Experience with analyzing and reporting… more
- Syneos Health Careers (New Orleans, LA)
- …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 ... Market Access, Public Affairs, State and Government Affairs, Trade and Specialty Pharmacy Accounts while abiding by all corporate and industry policy and procedures.… more
- Marsh & McLennan Companies, Inc. (Atlanta, GA)
- … Medicare Advantage markets Medicare Advantage bid development , both Part C and D Setting pricing assumptions, trends, and pricing methodologies Medical ... and pharmacy claims analysis, including benchmarking to applicable industry experience...related field 4+ years of actuarial experience in the Medicare Advantage industry focused on Part C… more
- Pharmacy Careers (Denver, CO)
- … 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
- 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
- CVS Health (Hartford, CT)
- …and external cross-functional business issues. Preferred Qualifications: + Pharmacy and Medicare Part D experience strongly preferred Education: + ... with heart, each and every day. Position Summary: The AVP, Actuary - Medicare Part D is responsible for analyzing and forecasting the financial performance… 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)
- …claim 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
