- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …requests from providers via phone and fax for the Retail Pharmacy, Medicare Advantage Part D, Home Infusion Therapy, and Medical Utilization Management benefits. ... compliance with all regulatory requirements. + Support product portfolio, including Medicare Part D which includes rotational weekend and holiday support for… more
- Highmark Health (Montpelier, VT)
- …share and risk share models and will be implemented for the Organization's Medicare Advantage, Medicaid, ACA, and commercial populations with the goal of maximizing ... interpretation, and outcomes strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS, risk revenue value streams, and population health… more
- Fallon Health (Worcester, MA)
- …to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that ... the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit...in a number of different key area's such as; Sales and Marketing, Provider Relations, Care Services, Pharmacy and… more
- Saint Francis Health System (Tulsa, OK)
- …knowledge of healthcare billing and reimbursement processes, particularly related to Medicare and Medicaid. Essential Functions and Responsibilities: Assists in the ... analytics tools to enhance audits and provides continuous monitoring. Provides oversight to sales tax recovery for taxable items utilized directly on Medicare … more
- Organon & Co. (Plymouth Meeting, PA)
- …state government pricing programs, including Medicaid Drug Rebate Program (MDRP), 340B, Medicare Part B/D, and the Veterans Affairs (VA)/Department of Defense (DOD) ... transactional data to ensure correct classification and identification of eligible sales . + Assist with GP system migration, updates, testing, and documentation… more
- The Cigna Group (Morris Plains, NJ)
- …of content development activities that influence how Regulated Markets lines of business ( Medicare , Medicaid, EGWP, Marketplace) show up in the market. This team is ... + Basic PowerPoint skills with an aptitude for skill development preferred + Sales administration experience a plus + Basic data and reporting tracking abilities +… more
- AbbVie (Mettawa, IL)
- …340B programs, spanning approximately $7.6B in Medicaid and $12.7B in 340B sales across both AbbVie and Allergan brands. Additional responsibility includes managing ... related to the Medicaid Drug Rebate Program, CMS (Center of Medicaid and Medicare Services). Furthermore, ensuring adherence to the US Commercial SOP's, DTPs, and… more
- Point32Health (NH)
- …functions including risk adjustment, population health, finance, operations, actuarial, and sales . **Job Description** Key Responsibilities/Duties - what you will be ... Contracting to ensure allied health and BH/SA networks and payment terms support Medicare division needs and goals. Assess and monitor allied payment rates and… more
- Kestra Medical Technologies, Inc (Kirkland, WA)
- …including, but not limited to, Finance, Investor Relations, People Operations, Sales , Marketing, Market Access, QA/RA, Supply Chain, Engineering, and Operations. ... Federal Food and Drug Administration and under contract with Medicare . Kestra maintains a drug free workplace and testing...Federal Food and Drug Administration and under contract with Medicare . Kestra maintains a drug free workplace and testing… more
- BD (Becton, Dickinson and Company) (Stuart, FL)
- …to ensure optimal coverage and maximize reimbursement from Commercial, Medicaid and Medicare plans. The individual will also have direct supervision of the contract ... and execution of the commercial reimbursement strategy including Medicaid and Managed Medicare plans. + Responsible and accountable for optimizing the Company's… more