- CVS Health (Phoenix, AZ)
- …Developing and maintaining a deep understanding of PBM financial levers within Commercial, Medicaid, Medicare Part D , and Public Exchange lines of business. ... of different lines of business (ex. fully insured, ASO, Medicaid, Medicare , Exchanges) to provide relevant recommendations and to influence client adoption… more
- Prime Therapeutics (Phoenix, AZ)
- …variety of constituents **Preferred Qualifications** + Integrated health system or health plan experience + Medicare Part D and B experience + Call center or ... are an applicant with a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources at ### or email… more
- Banner Health (AZ)
- …You will also maintain confidentiality of business and protected health information. Experience in Part D Medicare Stars will be helpful in this role. ... formulary, member cost-sharing, and regulatory requirements, both AHCCCS and Medicare . Assures that pharmacy claims are adjudicating correctly. Maintains compliance… more
- Molina Healthcare (Scottsdale, AZ)
- …sample universes, and submission of SOPs, training materials, and/or other evidence as part of regulatory audits. EX: DMHC, CMS active audits. Responsible for acting ... or special projects as required. + Must have experience working in Medicare + Must have experience analyzing claims. **Job Qualifications** **REQUIRED EDUCATION:**… more
- CenterWell (Sun City, AZ)
- **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, ... care team consists of doctors, advanced practice professionals, Pharm D , Care Coach Nurse, MA, Behavioral health specialist, Quality...This role is considered patient facing and is a part of our Tuberculosis (TB) screening program. If selected… more
- CenterWell (Surprise, AZ)
- **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
- CenterWell (Phoenix, AZ)
- **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
- Humana (Phoenix, AZ)
- **Become a part of our caring community and help us put health first** Become a part of our caring community and help us put health first The Encounter Data ... PowerPoint) + Working knowledge of SQL + Familiarity with EDI X12 formats (837P/I/ D , 999, 277, 835, 270/271, 834) + Demonstrated ability to identify process gaps… more
- Humana (Phoenix, AZ)
- **Become a part of our caring community and help us put health first** The Staff Utilization Management Pharmacist is a clinical expert responsible for conducting ... an impact** **Required Qualifications:** + **Bachelor's degree or Doctor of Pharmacy (Pharm. D .) from an accredited college of pharmacy** + Active pharmacist license… more
- Hospice of the Valley (Phoenix, AZ)
- …unique opportunity to collaborate with leading experts in the field and be a pivotal part in our mission to help those in our community live well with dementia. ... dementia including those related to financial benefits. + Understanding of ALTCS, Medicare , and other insurance benefits relevant for older adults in Maricopa… more