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Community Health Choice (HMO D-SNP), a Medicare Advantage Dual Special Needs plan for people with both Medicare and Medicaid that combines Medicare Part A and Part B benefits, Medicare Part D prescription drug coverage, and Medicaid benefits with additional health benefits like dental, vision, transportation, and more.
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Report to the Senior Manager of Medicare Part D Compliance – Medicare Business Support. Legal Compliance Advisor - Medicare Part D/ Rx Service Operations.
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In depth knowledge of Medicare Part D programs and CMS contracted vendors, such as RPC. This position requires a deep understanding of Medicare Part D programs and meticulous attention to detail to maintain the integrity of member accounts.
$28.23 - $40.44 an hourExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Experience with Medicare part D insurance and QS-1 pharmacy billing system a plus. Experience with Medicare part D insurance and QS-1 pharmacy billing system a plus. Tara Pharmacy is seeking a full time Collection Specialist for its Orchard Park, NY facility.
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Prepare and analyze monthly estimates for Medicare Part D Risk Corridor and Coverage Gap Discounts. Oversee and support all Finance related Part C and Part D reporting requirements for Medicare.
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The Segment Marketing Senior Manager will oversee direct-to-consumer (DTC) marketing for the Cigna Medicare Part D (PDP) business, reporting to the VP of Marketing. DTC Marketing Senior Manager - Medicare - Hybrid page is loaded.
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Experience in health care, health plans, Covered California, Medicaid Managed Care Plans (MCPs), Medicare Advantage, Medicare Part D, Special Needs Plans (SNPs), and/or Medicare-Medicaid Plans (MMPs)/Cal MediConnect.
$33.66 - $42.92 an hourFull-timeExpandApply NowActive JobUpdated Today - UpvoteDownvoteShare Job
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Ensure compliance with government regulations such as Medicaid best price, Medicare Part D, and 340B Drug Pricing Program. Ensure compliance with government regulations such as Medicaid best price, Medicare Part D, and 340B Drug Pricing Program.
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Voluntary benefits include pet insurance, legal insurance, accident and critical illness insurance, long term care, elder & childcare, AD&D, auto & home insurance. Responsible for duties in support of departmental efficiencies which may include: greeting customers following Conifer standards of care, providing world-class customer service, answers inbound & outbound calls, performs PBX operations, executes reception/basic demographic quick registration data entry, and thoroughly explaining and secure Hospital & patient legal forms (i.e., Advance Directives, Conditions of Services, Consent for Treatment, Important Message from Medicare, EMTALA, etc.
$17.98 - $26.88Full-timeExpandApply NowActive JobUpdated Yesterday - UpvoteDownvoteShare Job
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Professionally handle incoming inquiries from providers regarding Medicaid Managed Long Term Care, Medicare Advantage and Medicare Part D Prescription Drug Plans including but not limited to inquiries regarding cost, billing, drug coverage, deductible and co-pays, prospective members and others regarding benefits, eligibility, product information, enrollment and/or other customer service inquiries.
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Must understand Medicare, Medicaid, and manage d care plan credentialing requirements, and must be familiar with CAQH (Council for Affordable Quality Healthcare) We deliver best-in-class care at comfortable, accessible neighborhood clinics where seniors can feel at home and become part of a vibrant, wellness-focused community.
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The Manager, Medicare Appeals and Grievances oversees the daily processing of Medicare grievances and appeals for Medicare Part C and D to ensure compliance with Centers for Medicare and Medicaid Services (CMS) regulations.
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Experience with Medicare Part D and Medicaid guidelines and requirements. Analyzes Medicare and Medicaid pharmacy and medical drug utilization data to identify trends and at-risk populations; recommend and develop appropriate interventions; monitors and takes actions on results.
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Works closely with all departments necessary to ensure that the processes, programs, and services are accomplished in a timely and efficient manner in accordance with CHG policies and procedures and in compliance with applicable state and federal regulations including Centers for Medicare and Medicaid Services (CMS) and/or Medicare Part D, Department of Managed Health Care (DMHC) and Department of Health Care Services (DHCS.
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Extensive experience in healthcare contracting, with a critical understanding of PBMs, National Health Plans, Medicare Part D/B, GPOs, VA/DoD, Medicaid, and the evolving market landscape.
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