Senior Medicare Regulatory Analyst

Job not on LinkedIn

🔥 9 minutes ago

🎸 Tennessee – Remote

🎸 Tennessee – Remote

💵 $55.9k - $123.5k / year

⏰ Full Time

🟠 Senior

🚔 Compliance

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Health Care Service Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Health Care Service Corporation is an independent licensee of the Blue Cross Blue Shield Association, serving nearly 23 million people across the United States with a wide range of health benefit solutions. The company provides health coverage options for various groups, including employers, individuals, families, as well as Medicare and Medicaid plans. In addition to health insurance, HCSC offers services such as pharmacy solutions, life and dental insurance, and health data technology. With nearly a century of experience, HCSC is dedicated to improving access to quality care, enhancing health outcomes, and reducing costs while maintaining a deep commitment to its members and local communities.

📋 Description

• Investigate and resolve high-profile Medicare Part D complaints and grievances • Ensure CMS regulatory compliance • Support audit activities • Manage drug recall communications • Coordinate emergency access-to-benefits processes • Partner across departments to implement operational and system improvements • Present Medicare trends and findings in meetings with management • Analyze data reports and develop and run database queries

🎯 Requirements

• Bachelor's degree in Business OR 3 years of experience with health insurance • 2 years of experience with health insurance benefits and/or operations • Knowledge of Medicare Part D products • Verbal and written communication skills • Ability to present Medicare trends and findings to management • Ability to organize multiple tasks and responsibilities • Ability to analyze data reports • Experience developing and running database queries • PC proficiency including Microsoft Word, Excel, PowerPoint, and Outlook • Knowledge of CMS software application MARx (preferred) • Knowledge of prescription drug coverage and CMS Part D regulations and guidelines (preferred) • Knowledge of prescription drug benefits and retail or other pharmacy operations (preferred)

🏖️ Benefits

• Curated development plans and professional development • 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 • Other incentives