- CVS Health (Atlanta, GA)
- …Key Responsibilities: + Lead the development and execution of actuarial analytics strategies for Medicare Advantage and Part D programs. + Inform and enhance ... The ideal candidate will have deep expertise in CMS Part C and D programs, Medicare...+ Represent the actuarial analytics function in discussions with senior leadership and external stakeholders. **Required Qualifications** + 8+… more
- Molina Healthcare (Augusta, GA)
- …sample universes, and submission of SOPs, training materials, and/or other evidence as part of regulatory audits. EX: DMHC, CMS active audits * Based on regulatory ... findings to management; Supports management with presenting results and recommendations to Senior Leadership and department staff. * Recommends new or updated job… more
- CenterWell (Savannah, GA)
- …trends and areas of opportunity in pharmacy utilization (pharmacy management) to impact Part D per Member per Month (PMPM) costs while maintaining high ... + This role is considered patient facing and is part of Humana/ Senior Bridge's Tuberculosis (TB) screening...**Preferred Qualifications** + Active and unrestricted DEA license + Medicare Provider Number + Medicaid Provider Number + Minimum… more
- CenterWell (Atlanta, GA)
- **Become a part of our caring community and help us put health first** Humana's Primary Care Organization is one of the largest and fastest growing value-based care, ... senior -focused primary care providers in the country, operating over...care team consists of doctors, advanced practice professionals, Pharm D , Care Coach Nurse, MA, Behavioral health specialist, Quality… more
- CenterWell (Atlanta, GA)
- **Become a part of our caring community and help us put health first** Humana's Primary Care Organization is one of the largest and fastest growing value-based care, ... senior -focused primary care providers in the country, operating over...care team consists of Doctors, Advanced Practice professionals, Pharm D , Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists,… more
- CenterWell (Savannah, GA)
- **Become a part of our caring community and help us put health first** Humana's Primary Care Organization is one of the largest and fastest growing value-based care, ... senior -focused primary care providers in the country, operating over...care team consists of Doctors, Advanced Practice professionals, Pharm D , Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists,… more
- 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 ... plus + Strong analytical, organizational, presentation, and problem solving skills preferred. + Medicare Part D experience is preferred. + Actuarial… more
- CenterWell (Atlanta, GA)
- **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 ... serve. Our care team consists of doctors, advanced practice professionals, Pharm D , care coach nurses, MAs, behavioral health specialists, quality based coders,… more
- 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 ... objectives. This role is responsible for partnering across Member Operations senior leadership, Client Engagement, and the Business Integration Teams to influence… more
- Prime Therapeutics (Atlanta, GA)
- …PBM industry, Medicaid, Medicare , and health plans + Pharmacist / Pharm D + Experience with contract language and risk mitigation concepts Every employee must ... Relations Sr Dir - Remote **Job Description** The Pharmaceutical Trade Relations Senior Director is responsible for managing Prime's Trade Relations program(s) for… more