- 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
- 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
- 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 (Northbrook, IL)
- …work closely with multiple internal departments such as Sales, Account Management, IT, Medicare Part D Services, Client Audit, Benefits, and Implementations ... - PBM Industry and plan design. - RxClaim adjudication or benefits knowledge. - Medicare Part D - PBM or claim adjudication knowledge. - Proficiency in IBM… more
- 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
- 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
- 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
- Molina Healthcare (Boise, ID)
- …The Operational/Regulatory Oversight Analyst works with health plans and operations departments to assess, oversee, and recommend business practices to ... Analyst develops and performs audits and oversight functions involving business-critical operations and vendor outsourcing arrangements for the company. The Analyst… more
- 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
- 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
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