• Mgr Medicare Part D Pharmacy…

    Prime Therapeutics (Oklahoma City, OK)
    …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
    Prime Therapeutics (07/24/25)
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  • Medicare Risk Adjustment Strategy Program…

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    operations , financing and revenue generating programs + Knowledge of Medicare Part D program, operations and industry trends + Proven ability to ... 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 (06/27/25)
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  • Lead Director, Medicare Actuarial Analytics…

    CVS Health (Boston, MA)
    …years of experience in Medicare Advantage actuarial pricing, bid development, and CMS Part C/ D operations . + 5+ years' experience working with CMS ... on enhancing pricing accuracy, optimizing bid strategies, and supporting Medicare operations through advanced analytics and actuarial...the development and execution of actuarial analytics strategies for Medicare Advantage and Part D more
    CVS Health (07/01/25)
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  • Program Delivery Lead - Part D Risk…

    Humana (Louisville, KY)
    …moderate to substantial. The Risk Adjustment Organization seeks a Program Delivery Lead for Part D Risk Adjustment. This role will partner with leaders to ... improve existing programs and develop next-generation initiatives to ensure Part D risk score documentation is timely, complete, and accurate, while promoting… more
    Humana (08/08/25)
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  • Nurse Leader RN, Maternity/L& D , NICU

    Central Maine Medical Center (Lewiston, ME)
    …the Nursing Director, the Nurse Leader is responsible for the day-to-day operations of assigned responsibilities and is accountable for assuring the consistent use ... staff and other department managers.c) Creates and sustains a culture of safety. d ) Leads and manages change effectively.e) Responds to change productively, promotes… more
    Central Maine Medical Center (07/10/25)
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  • Manager, Compliance (Duals & D -SNP…

    Centene Corporation (Austin, TX)
    …education required + Experience with D -SNP SMAC, regulatory requirements and/or operations required + Medicare managed health experience required Pay Range: ... 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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  • Billing and Follow-Up Representative-II (Hospital…

    Trinity Health (Farmington Hills, MI)
    …Performs the day-to-day billing and follow-up activities within the revenue operations for an assigned Patient Business Services (PBS) location. Serves as ... Vision, and Values in behaviors, practices, and decisions Performs daily activities as part of the billing and follow-up team in support of the revenue cycle… more
    Trinity Health (07/18/25)
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  • Sr. Coordinator, Enrollment Operations

    CVS Health (Scottsdale, AZ)
    …Coordinator determines eligibility and performs various enrollment and disenrollment processes for Medicare Part D individual plan members and employer ... **Required Qualifications** + 2-3+ years of healthcare industry experience, preferably with Medicare Part D , including patient/beneficiary services. +… more
    CVS Health (08/01/25)
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  • National Account Director

    Rhythm Pharmaceuticals (Boston, MA)
    …appropriate access and coverage for Rhythm's portfolio across key commercial self-insured employers and Medicare Part D payers. The NAD will develop and ... record of payer engagement and strategic account management in the commercial self-insured and/or Medicare Part D channels. The position reports into the VP,… more
    Rhythm Pharmaceuticals (07/31/25)
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  • Senior Coordinator, Financial Operations

    CVS Health (Scottsdale, AZ)
    operations -supporting members, ensuring accurate billing, and helping us stay compliant with Medicare Part D regulations. You'll work closely with ... who have experienced significant life events. Reinstate eligible members in accordance with Medicare Part D guidelines, ensuring full compliance. + **Weekly… more
    CVS Health (08/02/25)
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