• Medical Director -Pharmacy Appeals

    Humana (Tallahassee, FL)
    …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
    Humana (08/22/25)
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  • Representative II - Operations

    CVS Health (Tallahassee, FL)
    …every day. **Position Summary** As a Rep II, Operations, you will be directly supporting Medicare Part D members and providers with requests related to their ... by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines,… more
    CVS Health (08/22/25)
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  • Sr Dir Pharmacy Trade Relations - Remote

    Prime Therapeutics (Tallahassee, FL)
    …and all related partner/customer relationships including pharmaceutical manufacturers, with specific emphasis on Medicare Part D and Managed Medicaid. The Sr ... + Direct the oversight of Trade formulary strategies for Commercial, Exchange, Medicare Part D and/or Medicaid template formularies, including items such as… more
    Prime Therapeutics (08/08/25)
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  • Senior Product Owner

    CenterWell (Tallahassee, FL)
    …the delivery of associate-facing contact center technologies that support Pharmacy and Medicare Part D operations. This enterprise-wide platform empowers ... a related field. **Preferred Qualifications:** + Understanding of pharmacy operations and Medicare Part D . + Experience with contact center platforms and CRM… more
    CenterWell (08/23/25)
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  • Compliance Analyst Principal - Remote

    Prime Therapeutics (Tallahassee, FL)
    …(CHC) + Advanced degree in related area of study, such as Juris Doctor + Medicare Part D , Medicaid, and/or Affordable Care Act knowledge and experience ... Supports new client implementations + Supports all lines of business (commercial/HIM, Medicare and Medicaid) + Other duties as assigned **Education & Experience** +… more
    Prime Therapeutics (07/07/25)
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  • Compliance Analyst Principal (Performance…

    Prime Therapeutics (Tallahassee, FL)
    …(CHC) + Advanced degree in related area of study, such as Juris Doctor + Medicare Part D , Medicaid, and/or Affordable Care Act knowledge and experience ... or within a highly regulated industry, including experience with Medicare , Medicaid, and the Affordable Care Act (ACA) +...a disability and need a reasonable accommodation for any part of the employment process, please contact Human Resources… more
    Prime Therapeutics (07/25/25)
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  • Billing Specialist

    Polaris Pharmacy Services, LLC (Fort Lauderdale, FL)
    …and payor verification * Verify insurance and Medicaid coverage * Handle Dual Coverage, Medicare Part D , and Commercial Plans related to Long-Term Care ... Vision and Life insurance * 401(k) (available to both Part -Time & Full-Time employees) * Short-term and Long-term Disability...referral bonus program Join Polaris Pharmacy Services and be part of a team committed to excellence in long-term… more
    Polaris Pharmacy Services, LLC (08/22/25)
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  • Director, Government Pricing/Managed Care Rebate…

    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 ... you require reasonable accommodations/adjustments in completing this application, or in any part of the recruitment process, direct your inquiries to ###@bms.com .… more
    Bristol Myers Squibb (08/12/25)
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  • Director of Service Delivery

    Prime Therapeutics (Tallahassee, FL)
    …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
    Prime Therapeutics (06/24/25)
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  • Accounting Manager, Revenue and Reporting

    WelbeHealth (Tallahassee, FL)
    …of capitation payment model, including ability to track and analyze revenue streams (eg Medicare , Medicaid, Part D ) along with PACE rates and regulatory ... + Assist with month-end close, quarterly financial reporting, financial audit, Medicare /Medicaid audits, and other PACE specific projects + Keep a… more
    WelbeHealth (08/01/25)
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