- KPH Healthcare Services, Inc. (Gouverneur, NY)
- **Overview** **The selected candidate must have** **5+ years experience in Medicare Part D and/or EGWP programs.** **Scope of Responsibilities:** Provides ... oversight and management of Medicare Part D /EGWP program. **Job... + Support vendor relationships (eg Plan Sponsor), daily operations , and implementation of EGWP pharmacy programs + Understand… more
- CVS Health (Austin, TX)
- …You will be performing all work in accordance with Medicare Part D guidelines. As a Rep II, Operations , you'll show a high level of attention ... convenient and affordable. Position Summary As a Customer Service Rep II, Operations you will work closely with healthcare providers to process Prior Authorizations… more
- CVS Health (Hartford, CT)
- …- 3 plus year of Coverage Determination & Appeals experience. - 1plus year of Medicare PART B experience - MHK, RxClaim, and People Safe proficient. - Meeting ... quality and productivity metrics in current role. Education High School Diploma or equivalent GED Pay Range The typical pay range for this role is: $17.00 - $29.88 This pay range represents the base hourly rate or base annual full-time salary for all positions… more
- CVS Health (Hartford, CT)
- …Must be able to understand data sets and identify technological efficiencies within Medicare Part D bid development and submission processing. Position ... D subject matter expert supporting end to end Part D Product operations efforts...including bids, implementation, benefits, reporting and analysis. 2-3 Years Medicare Part D Experience; 1-2… more
- UCLA Health (Los Angeles, CA)
- …of member accounts, and issuance of invoices. This position requires a deep understanding of Medicare Part D programs and meticulous attention to detail to ... Description As a member of the Medicare Advantage Operations team, the ...and billing regulatory requirements + In depth knowledge of Medicare Part D programs and… more
- UCLA Health (Los Angeles, CA)
- …enrollment, disenrollment, and cancellation requests. This position requires a deep understanding of Medicare Part D programs and meticulous attention to ... Description As a member of the Medicare Advantage Operations team, the Senior...workgroups and other meetings + Ability to work as part of a team, collaborating with colleagues + Ability… more
- The Cigna Group (Bloomfield, CT)
- …or related field or equivalent experience + 3 or more years of relevant Medicare Part C and/or Part D work experience + Understanding of Agile and ... is responsible for leading small, mid-sized and large projects supporting Medicare commissions. Understands and evaluates business specific objectives and drives the… more
- CVS Health (Woonsocket, RI)
- …all types of pharmacy products including specialty drug, Medicare Part D and understanding of PBM operations + Working knowledge of Microsoft Office ... reprioritizing as needed + Knowledge of all types of health care products including HMO, PPO, Medicare Advantage and Medicare Part D + Knowledge of… more
- MyFlorida (Tampa, FL)
- …The primary technical duties of the position involve ADAP operations , Medicaid, Medicare Part D , Ryan White, Patient Assistance Programs (PAP), oversight ... discipline of subordinates. Responsible for the supervision, training, and operations , can perform at basic level in all areas.... including but not limited to contractual agreements (Medicaid, Medicare Part D , Ryan White),… more
- Universal Health Services (Reno, NV)
- …in one or more of the following topics required: + Commercial HMO/PPO/POS + Medicare Part D + Retail/Mail Service/Specialty pharmacy + Pharmaceutical benefit ... 2014. Prominence Health serves members, physicians, and health systems across Medicare , Medicare Advantage, Accountable Care Organizations, and commercial payer… more
- HCA Healthcare (Nashville, TN)
- …ensure all procedures in place comply with all regulations (Summary of Material Modification, Medicare Part D notices, privacy notices, etc.) + Manage all ... a difference. We are looking for a dedicated Benefits Operations Analyst like you to be a part...and custom documents such as Summary of Material Modifications, Medicare Part D notices as… more
- InnovaCare (San Juan, PR)
- …members, during and after natural disasters. Through the Florida MMM Line of Care, as a Part D sponsor, you will ensure that the member has adequate access to ... Job Description BUSINESS UNIT: MMM Holdings, LLC DEPARTMENT: Service Operations Department - Call Center POSITION: Customer Service Representative...their covered Part D drugs. Orlando Family Physicians, a… more
- BlueCross BlueShield of North Carolina (NC)
- … pharmacy program across Medicare Advantage, including DSNP. EGWP and the Medicare Prescription Drug Program ( Part D ) to include operational expense, ... Medicare Advantage, including DSNP, EGWP and the Medicare Prescription Drug Program ( Part D...to share and gain insights in all areas of Medicare work ( operations , quality, cost of care);… more
- CVS Health (Phoenix, AZ)
- …reporting and analytical tasks using Microsoft Excel and Access. + Working knowledge of Medicare Part D requirements in particular those pertaining to ... account team dedicated to serving a large federal client with employer, and Medicare /EGWP prescription benefit offerings. The role will be responsible to support the… more
- Catholic Health Initiatives (Lexington, KY)
- …Knowledge, Skills, Abilities and Training** + Knowledge of Medicaid, Medicare Advantage plans, Medicare Part D + Knowledge of hospital revenue cycle. + ... **Responsibilities** **Job Summary / Purpose** The Patient Assistance Coordinator/Pharmacy Operations Specialist is responsible for CHI Saint Joseph Health System's… more
- Humana (Torrance, CA)
- …Humana is seeking a Lead Insurance Product Manager to join our dynamic and committed Medicare Part D Product Development team. This individual will lead, ... for Part D benefits as part of Humana's Medicare Advantage Plans and...insights. + Experience working across multiple functional areas (eg, operations , finance, clinical, actuary, communications) + Excellent communication skills… more
- Bausch Health (Bridgewater, NJ)
- …responsible for managing and accounting for Commercial and Medicare Part D contracts and will oversee the daily operations of the contract management ... Review and approve rebate claims data received for managed care contracts, Medicare Part D contracts, and other commercial and government programs. Validate… more
- MyFlorida (Fort Pierce, FL)
- …payer sources is used appropriately. Screens for Medicaid eligibility, PAC Waiver eligibility, Medicare A, B, and D eligibility. Verifies VA benefits. Determines ... OPERATIONS & MGMT CONSULTANT II - SES -...Responsible for the direct supervision of the Ryan White Part B Case Management Staff Monitors compliance with Ryan… more
- Wellpath (Pembroke Pines, FL)
- …and reconciling the Accounts Receivable report. + Manage the preparation of monthly Medicare Part D collections reports, reconciling collections to ... Do The Right Thing!", and to collectively do our part to heal the world, one patient at a...healthcare billing landscape. **Key Responsibilities** + Oversee monthly billing operations for ancillary services under Medicare /Medicaid, ensuring… 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