• Actuary - Medicare Part D

    CVS Health (Atlanta, GA)
    …be fully remote.** Join a high-performing actuarial team supporting Aetna & SilverScript's Group Medicare Part D business. The primary responsibility of this ... manage multiple priorities. **Preferred Qualifications:** + ASA + Prior pharmacy or Medicare Part D experience + Prior health pricing experience + Experience… more
    CVS Health (08/24/25)
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  • Medical Director -Pharmacy Appeals

    Humana (Atlanta, GA)
    …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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  • Sr Dir Pharmacy Trade Relations - Remote

    Prime Therapeutics (Atlanta, GA)
    …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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  • Pharmacy Financial Analyst, Cost of Care…

    Elevance Health (Atlanta, GA)
    …and interprets complex pharmacy data to identify cost drivers and trend patterns within the Medicare Part D Individual and Group markets + Identifies and ... + Strong analytical, organizational, presentation, and problem solving skills preferred. + Medicare Part D experience is preferred. + Actuarial background is… more
    Elevance Health (07/25/25)
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  • Senior Product Owner

    CenterWell (Atlanta, GA)
    …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 (Atlanta, GA)
    …(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 (Atlanta, GA)
    …(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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  • Field Reimbursement Manager

    Otsuka America Pharmaceutical Inc. (Atlanta, GA)
    …of Centers for Medicare & Medicaid Services (CMS) policies and processes, especially Medicare Part D + Experience in "Buy and Bill" reimbursement ... environment + Nephrology experience strongly preferred + Comprehensive understanding of US healthcare system payer billing practices + Proficiency in MS Office suite **Skills and Abilities** + Excellent verbal and written communication skills + Strong… more
    Otsuka America Pharmaceutical Inc. (08/27/25)
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  • Program Manager - Pharmacy Network and Fraud…

    Elevance Health (Atlanta, GA)
    …PowerPoint preferred. + Project management certification preferred. + Marketing experience preferred. + Medicare Part D experience preferred. + Fraud waste ... per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. The health of our associates and communities is a… more
    Elevance Health (08/26/25)
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  • Director of Service Delivery

    Prime Therapeutics (Atlanta, GA)
    …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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