Medicare Part D Operation Manager Jobs (NOW HIRING)

Pharmacist Advisor As a Pharmacist Advisor you will be directly supporting Medicare Part D members and providers with requests related to their pharmacy benefits. Responsibilities: * You will be ...

... and Medicare Part D. This role provides strategic direction, oversight, and subject matter ... Risk Management * Conduct ongoing risk assessments related to pharmacy operations, Part D benefit ...

Present findings and recommendations to the Actuarial Manager. * Document model logic, assumptions ... with a focus on Medicare Part D pricing or pharmacy. * Completion of 4+ actuarial exams.

Present complex modeling results and recommendations to actuarial leadership and senior management ... Medicare Part D pricing or pharmacy analytics. * Associate of the Society of Actuaries (ASA ...

Experience with Medicare Part D required. * Prior Managed Care / PBM experience strongly preferred. * Proficiency with Microsoft Office * Strong data entry, multitasking, and problem-solving skills.

Five (5) or more years of experience supporting Medicare Part D operations, appeals, utilization management, pharmacy benefit management, healthcare compliance, audit activities, or program integrity ...

Minimum 3-5 years of experience in Medicare Part D administration, pharmacy benefits management, or managed care pharmacy operations. * Minimum one (1) year of experience in a PACE organization ...

... Manager and support CMS workgroup discussions on Part D COB operational matters * Assist with ... An incumbent Part D COB Transaction Facilitator, Medicare Part D eligibility system, or similar CMS ...

... Manager and support CMS workgroup discussions on Part D COB operational matters • Assist with ... Medicare Part D COB program • Working knowledge of NCPDP E1 transaction standards, matching ...

Medicare Part D Optimization: Analyze Prescription Drug Event (PDE) claims, formulary tier ... Ability to work collaboratively in a consulting environment and manage multiple project priorities.

Assists in overseeing operational compliance through activities such as universe and report reviews ... Bachelor's degree and 3 years' experience in health plans, regulatory compliance or risk management ...

Medicare Part D * Clinical Pharmacy * Pharmacy Benefit Management (PBM) * Managed Care * Clinical Case Review * Prior Authorization * Appeals Review * Clinical Documentation * Drug Information ...

Assists in overseeing operational compliance through activities such as universe and report reviews ... Bachelor's degree and 3 years' experience in health plans, regulatory compliance or risk management ...

Assists in overseeing operational compliance through activities such as universe and report reviews ... Bachelor's degree and 3 years' experience in health plans, regulatory compliance or risk management ...

As a Clinical Pharmacist Advisor Medicare you will be directly supporting Medicare Part D members ... Experience: * Previous experience in Managed Care/PBM environment (preferred). Education:

... managed care, pharmacy benefits, and Medicare regulations. Remote Clinical Pharmacist Advisor - Medicare Part D Location: 100% Remote Pay: $53.00 per hour Training Schedule: Monday-Friday, 9:00 AM-5 ...

... manager * Active state health insurance license (Life & Health or equivalent) * Completed AHIP certification (current year preferred) * Solid knowledge of Medicare Part A, B, C (Advantage), D, and ...

... Part D members and providers with requests related to their pharmacy benefits. You will be ... Experience Previous experience in Managed Care/PBM environment (preferred). Education Bachelor ...

... manager * Active state health insurance license (Life & Health or equivalent) * Completed AHIP certification (current year preferred) * Solid knowledge of Medicare Part A, B, C (Advantage), D, and ...

The Government Programs EGWP Manager is responsible for the implementation, operational oversight ... Strong operational acumen Preferred Qualifications * Health Plan Medicare Part D and/or EGWPs