Medicare Part D Pharmacy Manager

A company is looking for a Pharmacy Benefits Manager- Medicare Part D (Remote). Key Responsibilities Manage first level response and resolution of escalated pharmacy issues for multiple Medicare Part D plans Translate Medicare Part D concepts into practice and identify unique issues through complex claims analysis Participate in readiness activities for new benefit plan years and resolve inquiries related to the Medicare Part D plan Required Qualifications 3 years of Medicare Part D/Pharmacy benefit and/or PBM experience related to eligibility, benefits, and claims adjudication Minimum of 1 year of experience in pharmacy claim analysis and quality practices BA/BS degree preferred or equivalent work experience Knowledge of Medicare Part D guidelines and regulations Experience with Prior Authorization systems and compliance with CMS regulations

Apr 7, 2025 - 20:25

A company is looking for a Pharmacy Benefits Manager- Medicare Part D (Remote). Key Responsibilities Manage first level response and resolution of escalated pharmacy issues for multiple Medicare Part D plans Translate Medicare Part D concepts into practice and identify unique issues through complex claims analysis Participate in readiness activities for new benefit plan years and resolve inquiries related to the Medicare Part D plan Required Qualifications 3 years of Medicare Part D/Pharmacy benefit and/or PBM experience related to eligibility, benefits, and claims adjudication Minimum of 1 year of experience in pharmacy claim analysis and quality practices BA/BS degree preferred or equivalent work experience Knowledge of Medicare Part D guidelines and regulations Experience with Prior Authorization systems and compliance with CMS regulations