What are the responsibilities and job description for the Medicare Regulatory Analyst - Work from Home position at Health Care Service Corporation?
At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
This position is 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; and assisting MCO in coordination of the contract with CMS enterprise-wide.
Job Requirements
Exact compensation may vary based on skills, experience, and location
HCSC Employment Statement
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
To learn more about available benefits, please click https://careers.hcsc.com/totalrewards
Join HCSC and be part of a purpose-driven company that will invest in your professional development.
This position is 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; and assisting MCO in coordination of the contract with CMS enterprise-wide.
Job 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.
- Knowledge of CMS Medicare Advantage software applications
- Medicare Advantage and Prescription Drug Plan coverage including Regulations and Guidelines.
- CTM (Complaint Tracking Module)
- Knowledge of health benefits
Exact compensation may vary based on skills, experience, and location
HCSC Employment Statement
We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.
To learn more about available benefits, please click https://careers.hcsc.com/totalrewards