Sr Medicare Regulatory Analyst - WFH

HCSC • Nashville, TN

7d • Remote

About The Position

Responsible for investigating and resolving high-profile Medicare Part D complaints and grievances, ensuring CMS regulatory compliance, supporting audit activities, managing drug recall communications, coordinating emergency access-to-benefits processes, and partnering across departments to implement operational and system improvements.

Requirements

• Bachelor Degree in Business OR 3 years experience with health insurance
• 2 years experience with health insurance benefits and/or operations
• Knowledge of Medicare Part D product
• Verbal and written communication skills
• Ability to present Medicare trends and findings in meetings with management
• Ability to organize multiple tasks and responsibilities
• Ability to analyze data reports
• Experience developing and running queries in a database
• PC proficiency to include Microsoft Word, Excel, PowerPoint and Outlook

Nice To Haves

• Knowledge of CMS software application MARx
• Prescription Drug coverage and knowledge of CMS Part D Regulations and Guidelines
• Knowledge of Prescription Drug benefits as well as Retail or other Pharmacy operations

Responsibilities

• Investigating and resolving high-profile Medicare Part D complaints and grievances
• Ensuring CMS regulatory compliance
• Supporting audit activities
• Managing drug recall communications
• Coordinating emergency access-to-benefits processes
• Partnering across departments to implement operational and system improvements

Benefits

• health and wellness benefits
• 401(k) savings plan
• pension plan
• paid time off
• paid parental leave
• disability insurance
• supplemental life insurance
• employee assistance program
• paid holidays
• tuition reimbursement

What This Job Offers

• Job Type: Full-time
• Career Level: Senior