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Sup Medicare Operations

Remote: 
Full Remote
Contract: 
Salary: 
54 - 92K yearly
Experience: 
Senior (5-10 years)
Work from: 

Offer summary

Qualifications:

Bachelor's degree in related field or equivalent, 2-5+ years' experience in PBM/Managed Healthcare, Strong understanding of prescription claim processing and Medicare Part D benefits, MS Office proficiency and database familiarity.

Key responsabilities:

  • Manage Medicare operations teams and assign daily tasks
  • Ensure client satisfaction and compliance to CMS guidelines
  • Provide staff training and support for operational issues
  • Stay updated with CMS regulations and conduct regular assessments
MedImpact Healthcare Systems, Inc. logo
MedImpact Healthcare Systems, Inc. Pharmaceuticals Large https://www.medimpact.com/
1001 - 5000 Employees
See more MedImpact Healthcare Systems, Inc. offers

Job description

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Your missions

Exemption Status:
United States of America (Exempt)

$53,852 - $72,700 - $91,548

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing
solutions
that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Supervisor, Medicare Operations

Summary:  Oversees one or more Medicare Operations teams to ensure adequate support is provided to Part D clients.  Responds to questions and issues related to a variety of areas including but not limited to claims adjudication, accurate processing of Part D claim adjustments, Prescription Drug Event (PDE) activity, and Part D guidance as published by the Centers for Medicare and Medicaid Services (CMS). 

Essential Duties and Responsibilities include the following. Other duties may be assigned.

  • Provides day-to-day supervision of Medicare Part D Operations teams, including assigning daily duties and tasks. Provides direction and guidance to direct reports on operational issues; manages and delegates the work flow for the department; recruits, manages and retains the necessary resources to successfully perform the duties required of the team.

  • Ensures the team’s work deliverables are on time, within budget, meet quality goals, and timeframes expected by MedImpact's internal and external customers and the Centers for Medicare and Medicaid Services (CMS). Ensures client satisfaction through the timely completion of client inquiries. Participates in client meetings and provides adequate information to all related departments. 

  • Provides ongoing training for staff development on department related topics and software programs used by staff.  Partners with Organization Effectiveness to identify and fill training needs.  Provides direction and guidance to the staff on operational issues.  Assists staff members by helping to remove any roadblocks or impediments to successfully completing work deliverables.  Reviews and audits the team’s work product.

  • Organize, facilitates and leads meetings with internal as well as external clients to provide client support and ensure compliance with CMS guidelines.

  • Keeps up-to-date with Medicare Part D regulations and related CMS guidance. Proactively reviews CMS regulation and guidance related to Part D claim processing, claim adjustments, and coordination of benefits requirements.  Provides comprehensive assessment of requirements when CMS revises guidelines and executes process changes to ensure MedImpact and its client’s compliance to new guidelines.  

  • Attends and seeks out internal and external training and seminars to upgrade skills.  Keeps up-to-date with the industries best practices.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience                                            

Bachelor’s degree in a related field (or equivalent combination of education and experience) along with 2 – 5+ years’ related experience in a PBM or Managed Healthcare setting. 1 year of supervisory experience required. Must have a good understanding of prescription claim processing concepts and Medicare Part D benefits.

3 years of MedImpact experience plus an appropriate external leadership training program and internal mentorship with a seasoned leader (Mgr+) that must completed within 12 months in new position may substitute for the supervisory experience requirement.

Computer Skills

Proficiency with MS Office (Word/Excel/Outlook) and familiarity with databases.

The Perks:
  • Medical / Dental / Vision / Wellness Programs
  • Paid Time Off / Company Paid Holidays
  • Incentive Compensation
  • 401K with Company match
  • Life and Disability Insurance
  • Tuition Reimbursement
  • Employee Referral Bonus

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego,
California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/Veterans
OSHA/ADA:

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer:

The above
statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

Required profile

Experience

Level of experience: Senior (5-10 years)
Industry :
Pharmaceuticals
Spoken language(s):
Check out the description to know which languages are mandatory.

Hard Skills

Soft Skills

  • supervision
  • verbal-communication-skills
  • open-mindset
  • microsoft-office
  • Teamwork
  • Leadership

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