- Optum (San Antonio, TX)
- …Microsoft Office, Internet and e-mail Beginner level of knowledge of the Medicare Part D , particularly the pharmacy record review, claims, billing and ... improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel...prescription drug claims Working knowledge of Medicare Part B and Part D … more
- Optum (San Antonio, TX)
- …experience in a customer service setting 1+ years of experience with Medicare Part D , particularly the pharmacy record review, claims, billing, and ... of prescription drug claims Working knowledge of Medicare Part B and Part D coverage guidelines and payment methodologies. Retail pharmacy experience… more
- Optum (San Antonio, TX)
- …experience in a customer service setting 6+ months of experience with Medicare Part D , particularly the pharmacy record review, claims, billing and ... prescription drug claims Working knowledge of Medicare Part B and Part D ...D coverage guidelines and payment methodologies Previous retail pharmacy experience Bilingual (English/Spanish) Pay is based on several… more
- Optum (San Antonio, TX)
- …or hospital 6+ months medical terminology knowledge base Knowledge of the Medicare Part D , particularly the pharmacy record review, claims, billing and ... improve health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel...to internal staff, subcontractors and providers with respect to Medicare drug related issues Participates in and contributes to… more
- Optum (San Antonio, TX)
- …months of experience with knowledge of medical terminology Knowledge of the Medicare Part D , particularly the pharmacy record review, claims, billing and ... improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel...to internal staff, subcontractors and providers with respect to Medicare drug related issues Participates in and contributes to… more
- CVS Health (West 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, R,… more
- Stratis Group (Fort Worth, TX)
- … & Medicaid Services (CMS) policies and processes with expertise in Medicare ( Part D for Pharmacy Benefit products) Proven ability to develop and ... include ensuring understanding of the reimbursement process particularly in Retail Pharmacy , field reimbursement services, and payer landscape. The FRM may also… more
- Medasource (Detroit, MI)
- …operational processes for current and future Clinical Pharmacy Star Measures and Medicare Part D products. This includes executing member, provider and ... Role: Pharmacy Technician Location: Remote Duration: Contract SUMMARY: The...resolving claims issues and member complaints *Review calls between Medicare Part D members and… more
- Remedi SeniorCare Holding Corporation (Rosedale, MD)
- …and acts in accordance with Corporate Compliance Policies & Procedures: HIPAA/Privacy Policy Medicare Part D General Compliance and Fraud, Waste and ... regulations, including but not limited to: CMS (Centers for Medicare and Medicaid) Boards of Pharmacy State...(Centers for Medicare and Medicaid) Boards of Pharmacy State Health Agencies DEA (Drug Enforcement Agency) OSHA… more
- Pennsylvania Medicine (Lancaster, PA)
- …clinical programs, committee activities, etc Responsibilities: Minimum Required Qualifications: Pharm. D . and ASHP-accredited Pharmacy Practice Residency required ... (28 hours per week) Location: Various locations in the Lancaster area Department: Pharmacy and IV Solutions Summary: Provide clinical pharmacy services including… more
- CenCal Health (Santa Barbara, CA)
- …as those related to NCQA certification and implementation of the Medicare D -SNP line of business Qualifications Knowledge/Skills/Abilities Required: In-depth ... in coordination with Health Services staff Works collaboratively with the Pharmacy team on clinical appropriateness of medication utilization Establishes and… more
- Syneos Health Careers (Providence, RI)
- …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
- Syneos Health Careers (San Diego, CA)
- …and maximizer programs Knowledge and understanding of all payer segments (eg, Commercial, Medicare Part D ) required Bridge program experience Knowledge and ... as an FRM or RAM working specifically with PBM medications Extensive pharmacy benefit knowledge (specialty product specific) required, identifying and educating to… more
- Pharmacy Careers (Cincinnati, OH)
- … 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
