- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …patient support services and enrollment + Collaborate with Field Sales, Specialty Pharmacy Accounts, and other matrix partners + Manage daily field-based activities, ... in rare disease + Strong knowledge of Centers for Medicare & Medicaid Services (CMS) policies and processes, especially... & Medicaid Services (CMS) policies and processes, especially Medicare Part D + Experience in "Buy and Bill"… more
- CenterWell (Albany, NY)
- …+ Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare + Current nursing experience in Hospital, SNF, ... one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the… more
- CenterWell (Albany, NY)
- …Previous experience in utilization management within Insurance industry + Previous Medicare Advantage/ Medicare /Medicaid Experience a plus + Current nursing ... one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the… more
- Adecco US, Inc. (Utica, NY)
- …readiness and adoption. 7. Serve as a subject matter expert on Medicare and commercial payer structures, translating complex benefit data into actionable insights ... * Strong medical reimbursement experience with Buy & Bill and/or Specialty Pharmacy . * Experience supporting program specific drug therapy space, ie, oncology,… more
- CenterWell (Albany, NY)
- …quality and cost improvement for high-risk senior populations in full risk Medicare arrangements. This individual will help assess the value of each opportunity ... quality and value drivers in full risk care delivery, ideally in Medicare /seniors + Demonstrated ability to work collaboratively with clinical and operational… more
- Molina Healthcare (NY)
- …Responsibilities include research, analysis and modeling of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate ... Performs analysis across multiple states and lines of business ( Medicare , Medicaid, Marketplace ACA). **KNOWLEDGE/SKILLS/ABILITIES** + Compiling and organizing… more
- Catholic Health Services (Rockville Centre, NY)
- …by payor source, such as: TPN, Enteral Nutrition and Inotropic Agents for Medicare . Evaluates current and future clinical and service needs for existing and new ... but not limited to: O Intake O Clinical Operations: Pharmacy &/or Nursing O Warehouse Operations, if required O...Communicates any problems incurred directly to the Home Infusion Pharmacy Manger Perform other duties as directed by manager.… more
- New York State Civil Service (Albany, NY)
- …and, (iv) University at Buffalo and its Schools/Colleges of Medicine, Nursing, Pharmacy , Dental Medicine, Social Work, and Public Health and Health Professions.- ... management and medical malpractice; health information technology; managed care; Medicare /Medicaid Conditions of Participation (CoPs) and Conditions for Coverage… more
- CenterWell (Albany, NY)
- …3 or more years experience in a high-volume community or mail order pharmacy practice environment + Previous experience in utilization management + Education: BSN or ... a related field + Health Plan experience + Previous Medicare /Medicaid Experience a plus + Call center or triage...largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health… more
- Blue Matter (New York, NY)
- …impact on access + Demonstrated subject matter expertise in both the medical and pharmacy benefit across all major US payer segments (eg, Commercial, Medicare , ... long-term care settings + Prior experience in both medical benefit and pharmacy benefit specialty therapeutic areas + Prior experience fielding primary market… more