- GEHA (Lee's Summit, MO)
- …and a personalized customer experience, sustained by a nimble and efficient organization. The Medicare Part D Performance Management Specialist will ... for monitoring contractual, operational, reporting, and regulatory requirements for Medicare Part D / EGWP...EGWP on all lines of business. + Monitor key performance indicators in clinical, operational, and vendor management areas… more
- KPH Healthcare Services, Inc. (East Syracuse, 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...of new or changed rules and/or regulations + Identify performance and compliance risks and communicates to leadership and/or… more
- BlueCross BlueShield of North Carolina (NC)
- **Job Description** This Consulting Actuary with a Medicare Part D focus on the Medicare Pricing team, will provide pricing, forecasting, and strategic ... Medicare products with a particular emphasis on Medicare Part D . You will...such as competitive health benefits, bonus plans based on performance , 401(k) with employer match, paid time off (plus… more
- Healthfirst (NY)
- …areas such as Risk Score Accuracy, Medicare Clinical Programming and Operations, Provider Performance , Medical and Pharmacy Part D cost savings, and ... Programming and Operations + Provider performance + Medical and Pharmacy Part D cost savings + Medicare Star Ratings/member experience. **Compliance &… more
- Walworth County (Elkhorn, WI)
- …This position is responsible for assisting Medicare beneficiaries with enrollment issues regarding Medicare Part D , Medicare Part C (Advantage ... or restrict the tasks that may be assigned. Perform Medicare Part D drug assessments...direction is available as requested. These decisions directly impact performance in the job and/or the work unit within… more
- Banner Health (AZ)
- …position is responsible for assisting with ensuring ongoing compliance and operational performance of new and extant Medicaid, Medicare and Commercial programs ... (BPN) is a nationally recognized healthcare leader that integrates Medicare and private health plans. Our main goal is...Income Subsidy (LIS) match rates, monthly encounter data and Part C and D reporting, Policies, Evidence… more
- CVS Health (Nashville, TN)
- …Summary** Directs the formulation, implementation and milestone tracking for business plans as Part of the Medicare benefit and product cycle. Directs the ... years of Managed Care experience in health plan and/or PBM roles 15+ years Medicare experience **Education** Pharmacist, BS or Pharm D with active, unrestricted… more
- Central Maine Medical Center (Lewiston, ME)
- …principles for inter/intra departmental interactions.c) Develops tools and collects data as indicated. d ) Uses data to drive Performance Improvement: able to ... 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
- The Cigna Group (Tampa, FL)
- …Technician in the Stars Pharmacy Call Center will work within the Part D Medication Adherence area of the Cigna Medicare Stars department. The Star rating ... system was developed by the Centers for Medicare & Medicaid Services (CMS) to measure the quality...Meet service level goals (ie, call quality, daily/weekly call performance expectations, etc.). + Maintain member privacy by strictly… more
- InnovaCare (Guayama, 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 ... Proficiency with Microsoft Office Suite19. Knowledge of CMS regulations PERFORMANCE MEASUREMENTS* Reporting functions are completed accurately and timely,...their covered Part D drugs. Orlando Family Physicians, a… more