Responsibilities
- responsible for receipt and coordination of CMS MA-PD and PDP escalated complaints
- submission of member and marketing materials to CMS for HCSC’s Medicare Advantage and Prescription Drug Plans
- applying CMS regulations pertaining to Medicare Advantage and Prescription Drug Plans to the review of member and marketing materials prior to submission to CMS
- providing assistance and guidance regarding Medicare Advantage and Prescription Drug Plan regulations to HISC staff
- working with other areas of the organization on the development, testing and implementation of organization, process and system changes to ensure the requirements of the Medicare Advantage and Prescription Drug program are met
- assisting MCO in coordination of the contract with CMS enterprise-wide
Requirements
- Bachelor’s degree in business OR 2 years’ experience with health insurance
- 1 year of experience with health insurance benefits and/or operations
- Knowledge of Medicare advantage 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 Lotus Notes
Hard Skills
- health insurance operations
- Medicare Advantage product knowledge
- data analysis
- database queries
Soft Skills
- verbal communication
- written communication
- presentation skills
- organizational skills
Certifications & Qualifications
- Bachelor's degree in business
Industry Keywords
- CMS regulations
- Medicare Advantage
- Prescription Drug Plans
- escalated complaints
- member materials
- marketing materials
Tools & Technologies
- Microsoft Word
- Microsoft Excel
- Microsoft PowerPoint
- Lotus Notes
Medicare Regulatory Analyst Arbeitgeber: Jobtailor
Als Global Director B2B – Business Development bei uns profitieren Sie von einer dynamischen und innovativen Arbeitsumgebung, die auf Zusammenarbeit und Kreativität setzt. Wir bieten Ihnen nicht nur attraktive Vergütungsmodelle und umfassende Weiterbildungsmöglichkeiten, sondern auch die Chance, in einem internationalen Team zu arbeiten, das Vielfalt und persönliche Entwicklung fördert. Unsere Unternehmenskultur legt großen Wert auf Flexibilität und Work-Life-Balance, sodass Sie Ihre Karriereziele in einem unterstützenden Umfeld erreichen können.
