- Humana (Nashville, TN)
- …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
- Prime Therapeutics (Nashville, TN)
- …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
- CenterWell (Nashville, TN)
- …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
- Prime Therapeutics (Nashville, TN)
- …(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 (Nashville, TN)
- …(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
- CVS Health (Nashville, TN)
- …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 (Nashville, TN)
- …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
- WelbeHealth (Nashville, TN)
- …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
- BrightSpring Health Services (Knoxville, TN)
- …the benefits of Original Medicare (Parts A and B) with prescription drug coverage ( Part D ). The Signature Advantage Plan is a unique plan allowing members to ... approved sales and marketing presentations in accordance with applicable Centers for Medicare & Medicaid Services (CMS) and State guidelines and standards. + Conduct… more
- CenterWell (La Vergne, TN)
- **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