- Prime Therapeutics (Washington, DC)
- …projects simultaneously **Preferred Qualifications** + Pharmacy Benefit Management/health care experience + Medicare Part D , Medicaid, and/or Affordable Care ... passion and drives every decision we make. **Job Posting Title** Compliance Analyst - Medicare Part B- REMOTE **Job Description** Job Description The Compliance… 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
- GEHA (Lee's Summit, MO)
- …Oversight & Performance Management** + Day to day management of the commercial PBM and Medicare Part D / EGWP administrator relationships for the FEHB and ... a nimble and efficient organization. The Director of Pharmacy Operations & PBM Management will guide and improve our...Health Benefits (PSHB) along with those for CMS for Medicare Part D / Employer… more
- VNS Health (Manhattan, NY)
- …with governmental regulations in this area. * Monitors premium billing to members for Medicare Part D . Analyzes monthly billing financials and works reports ... Accounts Payable to request payments as necessary. * Reviews Medicare Part D Prescription Drug...and procedures designed to improve efficiency of department business operations . * Maintains up-to-date knowledge of Medicare … more
- Martin's Point Health Care (Portland, ME)
- …and state laws and regulations and applicable accreditation standards + Expert knowledge of Medicare Part D regulations + Proven skills developing high ... to Work" since 2015. Position Summary The Director Pharmacy & Quality Operations is responsible for the oversight and execution of comprehensive strategic planning… more
- UNC Health Care (Holly Springs, NC)
- …the Centers for Medicare and Medicaid Services (CMS). In addition, as part of the UNC Health Rex network, Holly Springs Hospital benefits from the collective ... **_Rex Holly Springs Hospital is proud to be a part of southern Wake County, offering residents and their...leader to join their leadership team to oversee Nursing Operations , along with Surgery, Pharmacy, Care Management, and Rehab… more
- Lumeris (New York, NY)
- …create a system of care that every doctor wants for their own family and become part of a community that values its people and empowers you to make an impact. ... **Position:** Senior Director, Partner Operations **Position Summary:** Provides executive leadership and oversight of...or similar degree + Experience in managed care and/or Medicare Advantage **Working Conditions** + While performing the duties… more
- DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
- …Plan's Medicare Prescription Drug Program, including compliance and oversight of Medicare Part D laws, regulations and reporting requirements, benefit ... Perform medical necessity reviews for formulary exceptions and prior authorizations according to the Medicare Part D defined guidelines + Work with the… more
- Walgreens (Deerfield, IL)
- …able to address/understand/discuss complex reimbursement systems and flow of the healthcare dollar ( Medicare Part B/ D , ACOs, ASOs, GPOs, Hospitals, etc.). ... serves as a resource for other Account Managers, Field Operations , and plays a lead role on key region...experience with billing procedures for hospital, medical offices and Medicare (B / D benefits). + Experience… more
- Highmark Health (Camp Hill, PA)
- …and authority. + As a seasoned Group Retiree market expert ( Medicare Advantage, Medicare Supplement, Part D , Medicare Exchanges) this leader will ... and staff productivity.Plan, organize, staff, direct and control the day-to-day operations of the department; develop and implement policies and programs as… more