- Prime Therapeutics (Columbus, OH)
- …department. Works to ensure established rules, policies, and procedures are implemented so that Medicare Part D operations are successful, efficient, ... drives every decision we make. **Job Posting Title** Mgr Medicare Part D Pharmacy Programs...Provides the technical and leadership skills that ensure successful Part D pharmacy operations and… more
- Molina Healthcare (Cincinnati, OH)
- …data elements. + Collaborate with internal teams-including IT, Risk Adjustment operations , and clinical teams-to ensure accurate and consistent data interpretation. ... + Participate in internal simulations and mock audits as part of proactive audit readiness. + Contribute to the...of experience in data analytics, business intelligence, or healthcare operations + Foundational proficiency in SQL and exposure to… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us...as we prepare for the launch of Fully Integrated D -SNP (FIDE) plan in 2026. This individual will focus ... put health first** The MBA Intern - Illinois Medicaid ( Part -time, Fall 2025) will contribute as a team member...on driving scalable, innovative initiatives with local market operations , clinical, and finance leaders that improve members health… more
- WelbeHealth (Columbus, OH)
- …of capitation payment model, including ability to track and analyze revenue streams (eg Medicare , Medicaid, Part D ) along with PACE rates and regulatory ... all aspects of our revenue recognition model under ASC 606, revenue operations , control environment, and all required state and federal reporting requirements.… more
- Humana (Columbus, OH)
- …to determine other liable parties due to Medicare set aside settlement arrangements for both Part C and Part D + Oversee development of a repository of ... + Assume lead role in working with the Enterprise Operations Enablement (EOE) team our Insurance AI Lean Business...of a process to make use of COB MSP Part C& D data provided by CMS to… more
- Prime Therapeutics (Columbus, OH)
- …variety of constituents **Preferred Qualifications** + Integrated health system or health plan experience + Medicare Part D and B experience + Call center or ... responsible for the strategic leadership and operational direction of Member Operations solutions related to interaction with Prime Therapeutics clients to… more
- CVS Health (Columbus, OH)
- …experience managing insurance, healthcare, or benefit accounts - Experience with Medicaid, Commercial, and/or Medicare Part D Plans In the role, you must be ... of contact and are responsible for overseeing all their day-to-day PBM operations . Account Managers act as the liaison between clients and cross-functional internal… more