- TriHealth (Cincinnati, OH)
- …loading all contracts into required systems/vendors, and managing the provider manual; Lead all Medicare Part D operations , including managing PBM and ... pharmacy services vendors; Oversee enrollment operations for Medicaid and Medicare , ...maintain effective monitoring programs for claims processing, enrollment reconciliation, Medicare Part D , RAPS, and… more
- Thrifty White Pharmacy (Thief River Falls, MN)
- …B requirements. *Resolve any rejected claims or billing issues. *Assist customers with Medicare Part D inquiries. *Maintain accurate prescription records. ... at the top of their license, making them an invaluable asset to our pharmacy operations . As a dynamic organization, we have a variety of different practice sites and… more
- Prime Therapeutics (Oklahoma City, OK)
- …department. Works to ensure established rules, policies, and procedures are implemented so that Medicare Part D operations are successful, efficient, ... drives every decision we make. **Job Posting Title** Mgr Medicare Part D Pharmacy Programs...Provides the technical and leadership skills that ensure successful Part D pharmacy operations and… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- … operations , financing and revenue generating programs + Knowledge of Medicare Part D program, operations and industry trends + Proven ability to ... by visiting our Company Culture (https://careers.bluecrossma.org/us/en/culturepage) page. If this sounds like something you' d like to be a part of, we' d love… more
- CVS Health (Boston, MA)
- …years of experience in Medicare Advantage actuarial pricing, bid development, and CMS Part C/ D operations . + 5+ years' experience working with CMS ... on enhancing pricing accuracy, optimizing bid strategies, and supporting Medicare operations through advanced analytics and actuarial...the development and execution of actuarial analytics strategies for Medicare Advantage and Part D … 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
- Central Maine Medical Center (Lewiston, ME)
- …the Nursing Director, the Nurse Leader is responsible for the day-to-day operations of assigned responsibilities and is accountable for assuring the consistent use ... staff and other department managers.c) Creates and sustains a culture of safety. d ) Leads and manages change effectively.e) Responds to change productively, promotes… more
- Molina Healthcare (Boise, ID)
- …The Operational/Regulatory Oversight Analyst works with health plans and operations departments to assess, oversee, and recommend business practices to ... Analyst develops and performs audits and oversight functions involving business-critical operations and vendor outsourcing arrangements for the company. The Analyst… more
- Trinity Health (Farmington Hills, MI)
- …Performs the day-to-day billing and follow-up activities within the revenue operations for an assigned Patient Business Services (PBS) location. Serves as ... Vision, and Values in behaviors, practices, and decisions Performs daily activities as part of the billing and follow-up team in support of the revenue cycle… more
- Cambridge Health Alliance (Cambridge, MA)
- …PACE and HPO. * Lead internal and external audit preparation and response, including Medicare Part D and Enrollment Data Verification. * Develop and ... Lead government relations as they pertain to Health Plan Operations . * Manage all aspects of Medicare ...for smart, committed, compassionate people who want to be part of making our vision of better health and… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …(eg PBM) to assist in the development, communication and implementation of Commercial and Medicare Part D formulary and clinical program offerings. + ... UM activities to ensure that all Commercial (Pharmacy and Medical benefits) and Medicare Advantage Part D coverage determination requests are processed… more
- Ascendis Pharma (Princeton, NJ)
- …customers including private and public payers, national and regional health plans, state Medicaid, Medicare Part B and D , VA/DOD, PBM's, Employers, IDNs, ... skills. Ascendis Pharma is looking to hire a Senior Manager, Contract Operations to join our team. Responsibilities will include implementing and executing… more
- Ascendis Pharma (Princeton, NJ)
- …and managing BPO service providers. + Familiarity with government pricing implications (Medicaid, 340B, Medicare Part D ) is a plus. + Excellent project ... seeking a highly motivated Senior Manager (Contractor) to support our Contracting Operations function within the Market Access organization. This individual will be… more
- CVS Health (Woonsocket, RI)
- …(Prescription benefit Management) industry experience + Rx Claim Adjudication System experience + Medicare Part D experience + Experience with SQL ... IL **Position Summary** As a Senior Financial Analyst, Financial Operations , put your skills to use in a challenging...candidate to join and to grow with our finance operations team. This Senior Financial Analyst, Adjustment Reporting 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 ... the team to operationalize the BMS 340B strategy for Managed Care Rebate Operations and understand broader 340B landscape + Lead team and work collaboratively with… 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
- WellSpan Health (Lewisburg, PA)
- …synchronizer, telemetry, external pacemaker). b. Suction c. Oxygen d . Intubation (esophageal, endotracheal, nasogastric, and nasotracheal). e. Ventilator/CPAP ... health organization serving central Pennsylvania and northern Maryland. Our high-performing Medicare Accountable Care Organization (ACO) is the region's largest and… 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 ... Perform medical necessity reviews for formulary exceptions and prior authorizations according to the Medicare Part D defined guidelines + Work with the… more
- NTT DATA North America (Merced, CA)
- …a detail-oriented and experienced DSNP Business Analyst with specialized knowledge in Medicare and D -SNP claims processing. The ideal candidate will bring ... DATA have focused on impacting the core of your business operations with industry-leading outsourcing services and automation. With our industry-specific platforms,… more
- TEKsystems (Morrisville, NC)
- …Skills + Insurance verification, Prior authorization, Case management, benefit investigation, medicare part d , benefit delivery, pharmaceutical insurance ... Top Skills Details + Insurance verification,Prior authorization,Case management,benefit investigation, medicare part d ,benefit delivery,pharmaceutical insurance… more
