- CVS Health (Pittsburgh, PA)
- …drugs covered under the pharmacy benefit. This specific role will focus significantly on Medicare Part D. You will use and develop a strong knowledge of specialty ... to support UM. Knowledge of regulations impacting UM for Medicare clients is preferred. It will be necessary to...It will be necessary to create clinical content for Medicare Part B, including standard and client requested programs… more
- AmeriHealth Caritas (Philadelphia, PA)
- **Role Overview:** The Medicare Broker Relations Manager drives broker channel growth and ensures sales success. This position is responsible for cultivating and ... brokers and general agencies, while ensuring full compliance with Centers for Medicare & Medicaid Services (CMS), state, and internal regulations. This highly… more
- Humana (Harrisburg, PA)
- …a part of our caring community and help us put health first** Individual Medicare Advantage (iMA) Rapid Solutions owns the MA Pricing Model (web app hydrated via ... annual pricing of Humana's largest segment of business, individual plan Medicare Advantage. The team consists of actuaries and business technology professionals… more
- CVS Health (Pittsburgh, PA)
- …**Position Summary** The Clinical Pharmacist engages within the Medical Affairs - Medicare Formulary Administration team to support the creation and maintenance of ... the CVS Caremark's standard and client-modified Medicare formularies and utilization management edits. This role is...Managed Care residency - Demonstrated experience with formulary management, Medicare Part D, PBM and Managed Care, drug file… more
- Humana (Harrisburg, PA)
- …clinical experience + Knowledge of the managed care industry including Medicare , Medicaid and or Commercial products + Possess analysis and interpretation ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more
- Highmark Health (Harrisburg, PA)
- …experience in managed care pharmacy + 2 years of clinical account management experience in Medicare as part of the 4 year managed care experience + 2 years of ... experience analyzing pharmaceutical cost of care data **Substitutions** + None **Preferred** + Masters of Pharmacy or Masters of Business Administration + AMCP-ASHP accredited residency in managed care pharmacy + Experience leading or participating in Pharmacy… more
- Fresenius Medical Center (Harrisburg, PA)
- …options: + Educates on the availability of alternative insurance options (ie, Medicare , Medicaid, Medicare Supplement, State Renal programs and COBRA). + ... + Discusses insurance options when insurance contracts are terminated. Responsibilities involving Medicare and Medicaid include but are not limited to: + Determining… more
- Humana (Harrisburg, PA)
- …help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to… more
- Humana (Harrisburg, PA)
- …help us put health first** The Medical Director relies on fundamentals of CMS Medicare Guidance on following and reviewing home health, SNF, DME, dual Medicare ... teaching conferences, and other sources of expertise. Medical Directors will learn Medicare and Medicare Advantage requirements, and will understand how to… more
- Humana (Harrisburg, PA)
- …customers at the center of everything it does. Are you passionate about the Medicare population, looking for a role in management with the ability to directly impact ... self-driven individuals to join our team. Our Senior Manager, Medicare Sales, motivates and drives a team of ...Medicare Sales, motivates and drives a team of Medicare Sales Field Agents who sell individual health plan… more