- Novo Nordisk Inc. (Baltimore, MD)
- …level impact Demonstrates understanding of the local payer market including Medicare , Commercial and Medicaid benefit designs, Payer Coverage, Prescription Coverage ... Requirements, Step Therapy, Coverage Gap, Copays, and Deductibles and the impact on customer decisions Demonstrates understanding of territory customer groups and affiliations such as IPAs, Medical Groups, Health Systems, and Local Clinics and uses this to… more
- Merck & Co. (West Palm Beach, FL)
- …Key Account Manager, Nurse Educator, Field Reimbursement Associate, Medicare Account Executive, and more.Qualifications: Minimum Qualifications: Bachelor's Degree ... with 6 years Sales -experience-OR-a- minimum of high school diploma with at least 10 years of equivalent experience.Equivalent experience can be: Professional sales experience, work experience in the -healthcare/scientific- field (including pharmaceutical,… more
- Lundbeck (New York, NY)
- …internal and external partners and effectively addresses payer access issues ( Medicare , Medicaid, Commercial) using Lundbeck resources. Local Market & Therapeutic ... Area Expertise - Gather and validate key trends and dynamics in the market, map account linkages, and apply comprehensive therapeutic knowledge to uncover and prioritize unique opportunities. Demonstrates a clear and detailed understanding of the disease state… more
- Lundbeck (Bronx, NY)
- …anticipate and effectively address payer access issues (IDNs, Medicare , Medicaid, Commercial) using Lundbeck resources. Pharmaceutical Environment/Compliance - ... Ability to apply knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of pharmaceutical and medical products.REQUIRED EDUCATION,… more
- Merck & Co. (New Orleans, LA)
- …Leader, Key Account Manager, Nurse Educator, Field Reimbursement Associate, Medicare Account Executive, and more. Qualifications: Minimum Requirements: Bachelor's ... degree with at least 6 years of sales experience OR a minimum of high school diploma with at least 10 years of equivalent experience.Equivalent experience can be professional sales experience, work experience in the healthcare/scientific field (including… more
- Lundbeck (Rockford, IL)
- …to promoted portfolio using Lundbeck resources. Utilize deep understanding of Medicare payer landscape in addition to other payer channels including Medicaid ... and Commercial. Pharmaceutical Environment/Compliance - Ability to apply knowledge of pharmaceutical and regulatory environment, including accountability and adherence to Lundbeck policies and procedures and FDA regulations regarding the promotion of… more
- Merck & Co. (North Wales, PA)
- …agency partners and focus on customer segments (eg health plans, Medicare , Medicaid, federal, pharmacy, hospital, Group Purchasing Organization s, etc.). Primary ... Responsibilities: Work closely with our Company's internal functions (promotions, communications, medical affairs, brand marketing, etc.) and external agency partners to develop customer specific strategies and execute as appropriate to achieve access for… more
- Daiichi Sankyo, Inc. (Basking Ridge, NJ)
- …association, think tank, or pharmaceutical company required- Expertise in Medicare , Medicaid, 340B, and/or commercial insurance market required- Strong knowledge ... of federal legislative and rulemaking processes; experience researching and analyzing complex public policy issues required- Expertise in oncology and physician-administered medicines preferred Travel Ability to travel up to 20% Travel for business meetings as… more
- CHRISTUS Health (Alamogordo, NM)
- …automated InterQual(R) preferred. Knowledge of the regulatory environment, including Medicare Conditions of Participation, DNV standards, HIPAA, and reporting ... requirements. Submits appeals in a timely manner, upon request by the Director. Initiates discharge planning on assigned patients within 24 hours of admission. Revises discharge planning as indicated by changes in the patient's condition and circumstances.… more
- CHRISTUS Health (Santa Fe, NM)
- …including training on HEDIS measures and annual quality abstraction to support ( Medicare Shared Savings Program). This position is responsible for the oversight of ... the Mayo Clinic E-consult, E-boards data support. Enhanced Oncology Care Model CMS, Transition of Care Programs, PCMH, VBP via cloud based data applications. Manager is responsible for compilation and preparation of data results related to all aspects of care… more
- Elevance Health (Columbus, OH)
- **Audit & Reimbursement Senior- Medicare Cost Report Audit** **_Location: This is a virtual position, the ideal candidate will live within 50 miles of one of our ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare... Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs.… more
- Elevance Health (Columbus, OH)
- **Audit & Reimbursement III - Medicare Cost Report Audit** **Locations:** This is a virtual position; the ideal candidate will live within 50 miles of an Elevance ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare... Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs.… more
- Elevance Health (Columbus, OH)
- **Audit & Reimbursement Senior -** ** Medicare Cost Report Audit** **Locations:** This is a virtual position, the ideal candidate will live within 50 miles of an ... Health's family of brands. We administer government contracts for Medicare and partner with the Centers for Medicare... Medicare and partner with the Centers for Medicare and Medicaid Services to transform federal health programs.… more
- CommuniCare Health Services Corporate (Indianapolis, IN)
- Medicare Biller The CommuniCare Family of Companies currently owns/manages over 130 World-Class Nursing and Rehabilitation Centers, Specialty Care Centers, and ... of adult living communities. CommuniCare Health Services is currently recruiting a Medicare Biller for our Central Billing Office in Cincinnati, OH. PURPOSE/BELIEF… more
- Wider Circle (Mcallen, TX)
- …a fast-growing boutique insurance agency focused on helping people understand their Medicare Benefits. We work with underserved populations to help them navigate ... Medicare to identify the best benefits for their needs....Specialist to join our fast-paced team to connect with Medicare beneficiaries and help them schedule appointments with our… more
- Highmark Health (Charleston, WV)
- …models. This job is a highly skilled subject matter expert (SME) in Medicare STARS, Medicaid HEDIS and risk revenue streams and provides strategic, hands-on, office ... based support to PCPs for analysis of performance Medicare STARS, Medicaid HEDIS and risk revenue streams, identifies opportunities for improvement in value… more
- The Cigna Group (Franklin, TN)
- …and will work in the Franklin, TN office several days per week** ** Medicare Advantage position** The **Provider Contracting Lead Analyst** serves as an integral ... managers. Has knowledge of contracting process, contract management, network operations, Medicare fee schedules, financial terms, and metrics. Supports and provides… more
- USAA (Phoenix, AZ)
- …currently seeking a talented **Business Process Owner I** that will support Medicare Supplement Claims for USAA Life Company Claims Operations. This employee will ... the Life Company Chief Claims & Fraud Officer and will work on Medicare Supplement Claims activities and ensure a flawless execution of business-related processes,… more
- CVS Health (Hartford, CT)
- …is the senior HR thought-partner to the executive leadership team of the Aetna Medicare business, a business that announced a new leader earlier in 2024. This HR ... the SVP, CPO for Aetna and the President of Medicare to review and refresh the operating model of...to review and refresh the operating model of the Medicare business to best position this team to compete… more
- CVS Health (Hartford, CT)
- …more personal, convenient and affordable. Position Summary As a direct of the CFO, Medicare this role will work to ensure that the financial goals are aligned with ... to achieve its financial and strategic goals for our Medicare product lines through effective support of financial closing,...regulators, or auditors. This is a strategic position for Medicare Finance. The ED, Medicare Finance Consolidation… more
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