- SeniorCareRx (Northport, AL)
- …informationAssist in resolution of denied third party insurance claims, eg PDPs, Medicaid , etc.Locate medication from pharmacy supply area, count out, and ... accurately and timely within the parameters established by Senior Care Pharmacy guidelines, state and federal regulations, and per customer requirements. Communicate… more
- Merck & Co. (North Wales, PA)
- Job DescriptionAssociate Director , Pulmonary Arterial Hypertension (PAH) Payer Marketing & Access Strategy As Associate Director , PAH & Rare Disease Payer ... and tactics and serve the primary segment lead for US Payers, Pharmacy -Benefit Managers (PBM), and employers.This role will require robust engagement with key… more
- Intrepid USA (Elizabethtown, KY)
- …quality and patient careCompetitive pay with healthcare, dental, vision, pharmacy , Flexible Spending Account, Dependent Care Account benefits with affordable ... of our talent acquisition, recruiting process and team membersResponsibilities:As a Branch Director you will provide supervision and training to caregiver staff and… more
- Humana (Frankfort, KY)
- …on problems of diverse scope and complexity ranging from moderate to substantial. The Medicaid Pharmacy Director , internally known as a Clinical Pharmacy ... our caring community and help us put health first** The Clinical Pharmacy Lead monitors drug development pipeline, and medical literature, while providing clinical… more
- CareFirst (Baltimore, MD)
- …compliance, population health, and/or member/provider experience. + Analyzes Medicare and Medicaid pharmacy and medical drug utilization data to identify ... Maryland office; therefore, candidates must live within driving distance.** **PURPOSE:** Director , Pharmacy Government Programs is responsible for implementing… more
- Marshfield Clinic (Marshfield, WI)
- …together to support the most exciting missions in the world!** **Job Title:** Director - Hospital Pharmacy Services - Marshfield Medical Center **Cost Center:** ... (United States of America) **Job Description:** **JOB SUMMARY** The Director of Hospital Pharmacy Services is an...participation in any federally funded program, including Medicare and Medicaid . This is a condition of employment. Employee must… more
- CVS Health (Phoenix, AZ)
- …outcomes and lower health care costs. Caremark is recruiting for an Executive Director of Aetna Pharmacy Solutions who is responsible for end-to-end delivery ... of Aetna's Medicaid , Medicare, and SSI EGWP Pharmacy Benefits...plan administration, requirements, configuration, clinical and quality. The Executive Director has ownership of the successful delivery of Exchange… more
- Centene Corporation (Cheyenne, WY)
- …with Appeals experience, highly preferred. Job specific responsibilities: + Processing Pharmacy Appeals from Medicaid and Marketplace. + Place outbound ... competitive benefits including a fresh perspective on workplace flexibility. Pharmacy Coordinator - (Grievances, Appeals, and Prior Authorizations) Remote --… more
- Beth Israel Lahey Health (Boston, MA)
- …**Work Shift:** Day (United States of America) The Supervisor will report to the director of pharmacy shared services and will be responsible for the supervision ... technicians. This individual will also work closely with the director of pharmacy shared services on various...7. Monitors situations for fraud, waste, and abuse of Medicare/ Medicaid benefits and reinforces HIPAA and PHI protocols. (essential)… more
- Baptist Memorial (Covington, TN)
- …assistance for their prescriptions. The individual in this position supports the BSP Director , BSP Pharmacy Staff and Clinical Pharmacists to ensure that all ... patients are getting the most out of their specialty pharmacy services. The Pharmacy Technician - Specialty...communication occurs + Understand The Centers for Medicare & Medicaid Services (CMS) regulations and billing guidelines and complete… more
- Prime Therapeutics (Columbus, OH)
- …that are the responsibility of the Vendor. Requirements: + Extensive knowledge of Medicaid and NMAP claims processing and pharmacy benefits management. + At ... and drives every decision we make. **Job Posting Title** Director , Clinical Account Services - Remote Nevada **Job Description...pharmacy experience. + 5+ years of experience in Pharmacy Benefits Management (PBM), Health plan or Medicaid… more
- NHS Management, LLC (Irondale, AL)
- …information + Assist in resolution of denied third party insurance claims, eg PDPs, Medicaid , etc. + Locate medication from pharmacy supply area, count out, and ... accurately and timely within the parameters established by Senior Care Pharmacy guidelines, state and federal regulations, and per customer requirements. Communicate… more
- CVS Health (Springfield, IL)
- …Health, a Fortune 4 company, has an outstanding opportunity for a Medical Director - Medical Affairs. We need a Board Certified Oncologist for this opportunity.The ... of clinical leadership to various internal departments (eg, specialty pharmacy services, clinical product development, Enterprise Analytics, Compliance, Legal,… more
- New York State Civil Service (Albany, NY)
- NY HELP Yes Agency Mental Health, Office of Title Director Health Services, Central Office; Occupational Category Administrative or General Management Salary Grade ... for full and unconditional participation in the Medicare and Medicaid programs; orPossession of a Bachelor of Science or...of a Bachelor of Science or higher-level degree in pharmacy from a recognized college of pharmacy … more
- Prime Therapeutics (Columbus, OH)
- …exclusions, and rebate rates. **Responsibilities** + Knowledge of and experience with Medicaid pharmacy practice, managed care pharmacy practice, and/or ... our passion and drives every decision we make. **Job Posting Title** Sr Director , Value Based Pricing - Preferably on the West Coast **Job Description Summary**… more
- Lancaster General Health (Lancaster, PA)
- **Summary** **Job Description** **POSITION SUMMARY:** The Associate Medical Director , Hospitalist Services is responsible for assisting the Medical Director , ... as representative of the LGHP Hospitalists practice. The Associate director will report to LGHP Medical Director ...by CMS and the applicable State health department and Medicaid agency + Assist in developing, coordinating, and participating… more
- BrightSpring Health Services (Englewood, CO)
- …home infusion providers in the country. The Collection Manager will report to the Director of Revenue Cycle Management and work in our Centennial, CO office. Amerita ... of all Accounts Receivable, including but not limited to Medicare, Medicaid , commercial insurances and patient balances. The Collection Manager will perform… more
- Organon & Co. (Naperville, IL)
- **Job Description** **The Position** Under the guidance of the Director , Commercial Operations-Women's Health, the Women's Health Account Director (WH-AD) is the ... of contact for Organon for the following: + State Medicaid & Managed Medicaid Plans + State...Local Commercial Payers not covered by Regional Payer Account Director (RPAD). + Group Purchasing Organizations (GPOs) not covered… more
- CVS Health (Columbus, OH)
- …"base plan" and in the round robin based on "same or similar specialty" needs. * Pharmacy coverage - The medical director will perform pharmacy reviews. * ... to its membership. Aetna is looking for a medical director to be part of a centralized team that...+ years of experience in managed care (Medicare and/or Medicaid ) Experience with managed care (Medicare and Medicaid… more
- CSL Behring (King Of Prussia, PA)
- …brands within a defined group of Specialty Pharmacies, Commercial Payors (MCOs), Pharmacy Benefit Managers (PBMs) and Medicaid FFS. This includes acting ... The Associate Director , Corporate Accounts is responsible for managing all...+ Represents CSL Behring at key Payor/PBM and Specialty Pharmacy conferences. Contributes to training on appropriate topics for… more
