Sr Medicare Regulatory Analyst - WFH
Health Care Service Corporation•Nashville, TN
•$55,900 - $123,500•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
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What This Job Offers
Job Type
Full-time
Career Level
Senior
