• Clinical Pharmacist Advisor

    US Tech Solutions (May, OK)
    …by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, ... **Job Description:** + As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy… more
    US Tech Solutions (07/18/25)
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  • Pharmacist

    US Tech Solutions (AZ)
    …by reviewing information and completing timely and accurate documentation of all Medicare Part D requests, in compliance with Medicare guidelines, ... **Job Description:** + As an RPh Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy… more
    US Tech Solutions (07/18/25)
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  • Actuary - Medicare Part D

    The Cigna Group (Bloomfield, CT)
    …is designed to provide a designated full time support to Express-Script's external client's Medicare Part D business. This role will matrix with internal ... role will assist in development of actuarial analyses for Medicare Part D business, including...Bid Development, Desk Review & Audits + CMS Regulatory Compliance / Reporting + Financial Reconciliation Modeling + Trend… more
    The Cigna Group (08/04/25)
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  • Mgr Medicare Part D Pharmacy…

    Prime Therapeutics (Oklahoma City, OK)
    …fuels our passion and drives every decision we make. **Job Posting Title** Mgr Medicare Part D Pharmacy Programs - Remote, Pennsylvania **Job Description** ... the coordination of benefits in the pharmacy program with Medicare Part D plans. Provides...and leadership skills that ensure successful Part D pharmacy operations and program compliance within… more
    Prime Therapeutics (07/24/25)
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  • Senior Compliance Analyst, Duals ( D

    Centene Corporation (Austin, TX)
    …and SMAC regulatory filings. + Manages Duals (and Medicare with D -DSNP specific or separate) compliance reporting responsibilities and respond to inquiries ... working knowledge of laws and/or regulations in area of compliance , in particular Medicare , D -SNP,...other job-related factors permitted by law, including full-time or part -time status. Total compensation may also include additional forms… more
    Centene Corporation (08/08/25)
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  • Manager, Compliance (Duals & D -SNP…

    Centene Corporation (Austin, TX)
    …and delivering compliance training and education required + Experience with D -SNP SMAC, regulatory requirements and/or operations required + Medicare managed ... candidate will have:_** + **_Knowledge of Dual contract requirements (eg, Medicare -Medicaid plans)_** + **_Experience managing external audits and communicating with… more
    Centene Corporation (08/08/25)
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  • Senior Coordinator, Financial Operations

    CVS Health (Scottsdale, AZ)
    …significant life events. Reinstate eligible members in accordance with Medicare Part D guidelines, ensuring full compliance . + **Weekly Refunds** ... ensuring accurate billing, and helping us stay compliant with Medicare Part D regulations. You'll...and disenrollment process by ensuring accuracy, timeliness, and strict compliance with CMS standards. Collaborate with the automation team… more
    CVS Health (08/02/25)
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  • Director, Quality Improvement…

    Trinity Health (Gaithersburg, MD)
    … with CMS regulations. Has overall responsibility for the Medicare Part D fraud, waste and abuse Compliance Program. Assure annual review and approval of ... time **Shift:** Day Shift **Description:** **Director, Quality, Improvement and Compliance ** **Location:** Trinity Health PACE of Montgomery County, Gaithersburg, MD… more
    Trinity Health (07/10/25)
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  • Lead Director, Medicare Actuarial Analytics…

    CVS Health (Boston, MA)
    …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...end-to-end bid cycle process, including pricing, forecasting, and regulatory compliance . + Serve as a subject matter expert on… more
    CVS Health (07/01/25)
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  • Senior Medicare Markets Pricing Consultant…

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    … and its related financial models, including Medicare FFS, Medicare Advantage, Medicare Part D , and Medicare supplemental coverage. + Advanced ... by visiting our Company Culture (https://careers.bluecrossma.org/us/en/culturepage) page. If this sounds like something you' d like to be a part of, we' d love… more
    Blue Cross Blue Shield of Massachusetts (07/30/25)
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