Senior Medicare Regulatory Analyst

This is a fully remote position, open to applicants in Tennessee.

📋 Description

• Investigate and address high-profile complaints and grievances related to Medicare Part D.

• Ensure compliance with CMS regulations.

• Assist in audit processes.

• Oversee communication regarding drug recalls.

• Coordinate processes for emergency access to benefits.

• Collaborate with various departments to implement operational and system enhancements.

• Present findings and trends related to Medicare in management meetings.

• Analyze data reports and create as well as execute database queries.

⛳️ Requirements

• Bachelor's degree in Business or a minimum of 3 years of experience in health insurance.

• At least 2 years of experience in health insurance benefits and/or operations.

• Familiarity with Medicare Part D products.

• Strong verbal and written communication skills.

• Capability to present Medicare trends and findings effectively to management.

• Proficiency in organizing multiple tasks and responsibilities.

• Ability to analyze data reports competently.

• Experience in developing and executing database queries.

• Proficient in PC applications including Microsoft Word, Excel, PowerPoint, and Outlook.

• Knowledge of the CMS software application MARx is preferred.

• Understanding of prescription drug coverage and CMS Part D regulations and guidelines is preferred.

• Familiarity with prescription drug benefits and retail or other pharmacy operations is preferred.

🏝️ Benefits

• Tailored development plans and opportunities for professional growth.

• Comprehensive 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.

• Annual incentive bonus plan.

• Additional incentives.