- Prime Therapeutics (Pierre, SD)
- …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
- Independent Health (Buffalo, NY)
- …subject matter expert within product team in the review of Medicare Advantage and Part D operations and requirements. + Provide support in Medicare ... ability to design and develop adult learning programs OR Medicare Advantage or Part D ...training regarding practices and business processes to support the Medicare LOB and operations of the sales… more
- CVS Health (Austin, TX)
- …and every day. **Position Summary** As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their ... healthcare company by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare … more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …education required + Experience with D -SNP SMAC, regulatory requirements and/or operations required + Medicare managed health experience required + Business ... compliance department functions, including but not limited to, regulatory and D -SNP contract review and interpretation, periodic monitoring and auditing activities… 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
- Henry Ford Health System (Grand Blanc, MI)
- ADMINISTRATIVE ASSOCIATE + Department: L& D , Postpartum + Schedule: FT Nights 7pm-7:30AM M-F & EOWE + Hospital: Henry Ford Genesys + Location: Grand Blanc, MI A ... physicians, allied services, and visitors; ensure that information sharing of unit operations is maintained; communicate concerns to the management team for problem… more
- CVS Health (Hartford, CT)
- …all types of pharmacy products including specialty drug, Medicare Part D and understanding of PBM operations . + Working knowledge of Microsoft Office ... reprioritizing as needed. + Knowledge of all types of health care products including HMO, PPO, Medicare Advantage and Medicare Part D . + Knowledge of… more
- BrightSpring Health Services (Louisville, KY)
- …the benefits of Original Medicare (Parts A and B) with prescription drug coverage ( Part D ). The Signature Advantage Plan is a unique plan allowing members to ... Our Company Signature Advantage Overview The Chief Operations Officer (COO) is a pivotal member of...execution of core plan functions in line with CMS Part C & D regulations + Manage… more
- BlueCross BlueShield of North Carolina (NC)
- …Clinical Practice Management, Clinical Programs, Clinical Review, Clinical Trials Operations , Medicare , Medicare Part D , Medication Therapy ... and certifications and other business and organizational needs. Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*,… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …pharmacy performance guarantees, security audits, and other Production Operations duties + Oversee Medicare Part D Claims audits to ensure that all MAPD ... relationships throughout the organization including, but not limited to, Medicare Product, Medicare Operations , ...changes, and industry trends impacting Medicare including Medicare Part D program +… 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
- Access Dubuque (Dubuque, IA)
- Manager of Technical and Analytical Operations **Medical Associates** 1 Positions ID: ooDcwfwt Posted On 06/03/2025 **Job Overview** **Description** Medical ... Plans is hiring a **Manager of Technical and Analytical Operations ** to join our team! **Where You Will Be...of the quarterly reports and budget projections for the Medicare cost report. Preparation of all workpapers for the… more
- Lumeris (New York, NY)
- …create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact. ... **Position:** Senior Director, Partner Operations **Position Summary:** Provides executive leadership and oversight of...or similar degree + Experience in managed care and/or Medicare Advantage **Working Conditions** + While performing the duties… 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
- 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
- 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
- State of Colorado (Denver, CO)
- …with associated paperwork, picking up pharmaceuticals and paperwork from the units, process Medicare Part D claims, coordinates pickup and removal of ... follow: Deliver medications to treatment units, fill prescriptions, process Medicare part D claims, and...pharmaceuticals: + Order pharmaceuticals and supplies for the day-to-day operations of the pharmacy. + Receive the items and… more
- Highmark Health (Camp Hill, PA)
- …and authority. + As a seasoned Group Retiree market expert ( Medicare Advantage, Medicare Supplement, Part D , Medicare Exchanges) this leader will ... and staff productivity.Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as… more
- East Boston Neighborhood Health Center (Revere, MA)
- …annual MassHealth applications and Medicare Secondary Payers Surveys + Ensuring that all Medicare Part D YTD Explanation of Benefits are received and ... of the essential support staff who keep our operations running smoothly - every role at NeighborHealth is...knowledge of the overall Medicare eligibility of Part A, B and D + Verifying… more