- Conviva Senior Primary Care (Tampa, FL)
- Become a part of our caring community and help us put health first Humana's Primary Care Organization is one of the largest and fastest growing value-based care, ... Our care team consists of doctors, advanced practice professionals, pharm D , care coach nurses, medical assistants, behavioral health, specialists, quality-based… more
- CenterWell Senior Primary Care (Fort Worth, TX)
- Become a part of our caring community and help us put health first At CenterWell Senior Primary Care, we want to help those in the communities we serve, including ... Our care team consists of Doctors, Advanced Practice professionals, Pharm D , Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based… more
- Conviva Senior Primary Care (Corpus Christi, TX)
- Become a part of our caring community and help us put health first Humana's Primary Care Organization (PCO) is the largest and fastest growing value-based care, ... Our care team consists of Doctors, Advanced Practice professionals, Pharm D , Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based… more
- Molina Healthcare (San Antonio, TX)
- …Opportunity for a Texas licensed RN to join Molina to work with our Medicare members in the San Antonio service delivery area; candidates should reside in Bexar ... County. Part of the responsibilities of the role is to...to those candidates with previous experience working with the Medicare population within a Managed Care Organization (MCO). Mileage… more
- CenterWell Senior Primary Care (Houston, TX)
- Become a part of our caring community and help us put health first The Primary Care Physician (PCP) works as a lead in our team-based care environment. We are a ... Our care team consists of Doctors, Advanced Practice professionals, Pharm D , Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based… more
- Northwell Health Physician Partners (Mount Kisco, NY)
- …and diagnosis through treatment and follow-up. Northern Westchester Hospital, part of Northwell Health, provides quality, patient-centered care through a ... that surpass the standards defined by the Centers for Medicare & Medicaid Services (CMS) and the Hospital Quality...a result, our diversity and inclusion efforts are a part of everything we do - from education to… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …Description: This pharmacist clinician is a program manager, who is responsible for all Medicare Part D formulary creation and submissions, which includes ... for the current and upcoming contract years. This individual creates and executes the Medicare Part D formulary, delivering value and quality to the Plan's … more
- US Tech Solutions (May, OK)
- …06+ months contract **Note:** + Ideal candidates must have experience of Prior Authorization, Medicare Part D and Pharmacy Benefit Management experience. + ... **Job Description:** + As a Pharmacist Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy… more
- CVS Health (Chicago, IL)
- …role is primarily responsible for modeling pharmacy network contracting arrangements for Aetna's Medicare Part D business and providing actuarial support to ... financial projections/modeling. + Support development of pharmacy network assumptions for Aetna's Medicare Part D bids and forecasts. + Partner with the… more
- Health Care Service Corporation (Nashville, TN)
- …for driving delivery, contingency planning, business results, and strategic planning for Medicare Part D Pharmacy consisting of multiple programs, ... that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development.… more
- Prime Therapeutics (Salem, OR)
- …cost effective delivery of service; design, develop, and implement annual operating budget and the Medicare Part D annual bid + Partner with stakeholders and ... healthcare industry and recognition for government program expertise; strong understanding of Medicare Part C and D rules and regulations + Exceptional… more
- CVS Health (Concord, NH)
- …team, you will play a critical role in shaping and executing the organization's Medicare Part D formulary and product strategy. Leveraging your clinical ... skills. **Job Description Summary** + Support the development and implementing of Medicare Part D strategy through the execution of operational, functional,… more
- Corewell Health (Grand Rapids, MI)
- …adherence + Educate members on disease state and medication + Educate members on Medicare Part D benefits and drug coverage to increase understanding ... Pharmacy Intern, under the direct supervision of a licensed Medicare Quality pharmacist, will engage with Medicare ...licensed Medicare Quality pharmacist, will engage with Medicare members to improve medication adherence to Medicare… more
- US Tech Solutions (May, OK)
- …HAVE 6 months of experienced with Prior Authorization(required). + MUST HAVE experience with Medicare Part D + Must Have Pharmacy Benefit Management (PBM) ... experience. **Education:** + Pharm D . required with at least two years' experience as a pharmacist in Managed care environment. + Must have an active license in the… more
- Humana (Lincoln, NE)
- …Policies and Procedures, and clinical literature as appropriate. Medical Directors will learn Medicare Part D and Medicare Advantage requirements ... first** The Medical Director relies on broad clinical expertise to review Medicare drug appeals ( Part D & B). The Medical director work assignments involve… more
- Rhythm Pharmaceuticals (Boston, MA)
- …appropriate access and coverage for Rhythm's portfolio across key commercial self-insured employers and Medicare Part D payers. The Senior NAD will develop ... of payer engagement and strategic account management in the commercial self-insured and/or Medicare Part D channels. The position reports into the VP, Market… more
- US Tech Solutions (May, OK)
- **Job Description:** + As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy ... by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines,… more
- US Tech Solutions (AZ)
- …months contract** **Job Description:** + As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to ... by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines,… more
- US Tech Solutions (May, OK)
- …availability could be required. **Experience:** + Prior authorization experience preferred. + Medicare Part D experience required + Previous pharmacy ... of experience although 2-5 years is preferred. **Skills:** + Prior Authorization + Medicare Part D **Education:** + Bachelor's Degree Required, Pharm D … more
- Trinity Health (Gaithersburg, MD)
- …and correct CMS return files, RAPS, and encounter data. + Ensure compliance with Medicare Part D reporting requirements and prepare annual bid submissions. ... Health PACE (TH PACE) programs. This role manages revenue cycles for Medicare , Medicaid, and private pay, oversees expense cycles including vendors and medical… more
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