• Mgr Medicare Part D Pharmacy…

    Prime Therapeutics (Harrisburg, PA)
    …fuels our passion and drives every decision we make. **Job Posting Title** Mgr Medicare Part D Pharmacy Programs - Remote, Pennsylvania **Job Description** ... Manages the coordination of benefits in the pharmacy program with Medicare Part D plans. Provides the technical and leadership skills that ensure successful … more
    Prime Therapeutics (07/24/25)
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  • RPh Advisor - Med D

    CVS Health (Harrisburg, PA)
    …and every day. **Position Summary** As an RPh Advisor 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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  • Medical Director -Pharmacy Appeals

    Humana (Harrisburg, PA)
    …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 (Harrisburg, PA)
    …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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  • Associate Eligibility Specialist (Pittsburgh, PA)

    NTT DATA North America (Pittsburgh, PA)
    …& Skills:** + Minimum of 1 year of experience related to CMS guidelines and Medicare Part D enrollment processes. + Basic proficiency in Microsoft Excel, ... an effective strategy for gaining and maintaining competitive advantages when executed as part of an overall sourcing strategy. NTT DATA Services currently seeks a… more
    NTT DATA North America (08/19/25)
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  • Compliance Analyst Principal - Remote

    Prime Therapeutics (Harrisburg, PA)
    …(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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  • Manager Mid-Market & Small Group Retiree Solutions

    Highmark Health (Camp Hill, PA)
    …and authority. + As a seasoned Group Retiree market expert ( Medicare Advantage, Medicare Supplement, Part D , Medicare Exchanges) this leader will ... Continuously monitor and maintain knowledge of the Commercial, Group Retiree and Medicare markets and competition. + Develop strategies and tactics to optimize… more
    Highmark Health (06/04/25)
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  • Compliance Analyst Principal (Performance…

    Prime Therapeutics (Harrisburg, PA)
    …(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 - East Region

    Otsuka America Pharmaceutical Inc. (Harrisburg, PA)
    …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 **Qualifications Preferred** + Bachelor's degree **Skills and Abilities** + Excellent verbal… more
    Otsuka America Pharmaceutical Inc. (08/16/25)
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  • Ld Dir, PBM Underwriting

    CVS Health (Harrisburg, PA)
    …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
    CVS Health (08/09/25)
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