• 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 (04/18/25)
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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 (04/18/25)
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  • Senior Actuary - Medicare Part

    CVS Health (Chicago, IL)
    …and Aetna's exciting and growing government services pharmacy business. The primary focus is the Medicare Part D product strategy and pricing of MAPD, SNP ... and PDP Products. This role will focus on developing health care solutions for Medicare Part D members. The colleague provides actuarial support to ensure… more
    CVS Health (04/20/25)
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  • Compliance Analyst - Medicare

    Prime Therapeutics (Washington, DC)
    …projects simultaneously **Preferred Qualifications** + Pharmacy Benefit Management/health care experience + Medicare Part D , Medicaid, and/or Affordable Care ... our passion and drives every decision we make. **Job Posting Title** Compliance Analyst - Medicare Part B- REMOTE **Job Description** Job Description The … more
    Prime Therapeutics (04/24/25)
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  • Medicare Pharmacy Audit Programs Project…

    CVS Health (Scottsdale, AZ)
    Medicare Pharmacy Audit Programs Project Manager you will be responsible for administering Medicare Part - D Pharmacy Audit Programs. In this role, you will ... make business-critical decisions and develop strategies to maximize client compliance integrity. You will utilize a wide variety of...using SQL coding analytics. + Coordinating the correction of Medicare Part - D claims and PDEs… more
    CVS Health (04/25/25)
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  • Appeals Specialist ( Medicare )

    AmeriHealth Caritas (Philadelphia, PA)
    …This includes handling requests for decisions regarding denials of medical services and Part D drugs. ; **Key Responsibilities:** + Analyze and respond to ... the Supervisor of Appeals & Grievances and coordinates and performs all appeal-related duties within Medicare Advantage Dual Special Needs and Medicare -Medicaid.… more
    AmeriHealth Caritas (05/03/25)
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  • Customer Service Representative- Medicare

    Kelly Services (Avon, CT)
    …and email with empathy, patience, and professionalism + Assist members with insurance claims, Medicare & Part D questions, and prescription issues + Serve ... **Now Hiring: Customer Service Representative ( Medicare Focused) | Temp-to-Hire Opportunity** **Location: Avon, CT...Week: 35-37.5 hours based on lunch choice + Training: Compliance training required **Perks That Set Us Apart:** +… more
    Kelly Services (04/25/25)
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  • Medicare Sales Account Representative

    BrightSpring Health Services (Nashville, TN)
    …the benefits of Original Medicare (Parts A and B) with prescription drug coverage ( Part D ). The Signature Advantage Plan is a unique plan allowing members to ... approved sales and marketing presentations in accordance with applicable Centers for Medicare & Medicaid Services (CMS) and State guidelines and standards. + Conduct… more
    BrightSpring Health Services (04/03/25)
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  • (RN) HCS- D , COS-C - Registered Nurse…

    Northwell Health (Westbury, NY)
    …coding rules and regulations to the validation review process. + Reviews codes on Medicare /non- Medicare charts for compliance to rules and conventions. + ... Seeking RN - BSN or MSN candidates with a HCS- D - Home Care Coding Specialist-Diagnosis, COS-C Certificate for...the Medical Record. Job Responsibility + Audits and reviews Medicare /non- Medicare charts to ensure that proper standards… more
    Northwell Health (03/04/25)
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  • Nurse Leader RN, Maternity/L& D , NICU

    Central Maine Medical Center (Lewiston, ME)
    …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 ... meeting the goals, communicate the plan to staff and evaluate the outcome. d ) Maximizes care efficiency and throughput.e) Responsible and accountable for fiscal… more
    Central Maine Medical Center (04/11/25)
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