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Medicare Pharmacy Specialist

Company: VirtualVocations
Location: Henderson
Posted on: October 25, 2024

Job Description:

A company is looking for a Medicare Pharmacy Specialist to support the operations and compliance of the Medicare Pharmacy program.



Key Responsibilities

Oversee Pharmacy Benefit Manager (PBM) to ensure CMS compliance and manage operational aspects of Part D and Part C programs
Handle escalated issues related to claims, compliance, and coding errors, while providing subject matter expertise to internal staff
Participate in audits and foster CMS compliance awareness through regular meetings with vendors and internal teams


Required Qualifications

Bachelor's degree in business, health care administration, pharmacy, or a related field
2-5 years of experience in health plan or PBM operations, including Medicare Part D, depending on the level of the position
Medicare Part C (medical drug) experience preferred
Pharmacy technician certification preferred
Knowledge of Medicare appeal and grievance processes and guidelines

Keywords: VirtualVocations, Paradise , Medicare Pharmacy Specialist, Healthcare , Henderson, Nevada

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