Federal & Integrated Products Materials Reviewer NYC

The Federal & Integrated Products Materials Reviewer plays a critical role in supporting the Regulatory Operations team by managing regulatory requirements related to Medicare and MAP materials. This position is responsible for the ongoing oversight, analysis, review, and approval of all beneficiary- and provider-facing Medicare and MAP materials.

The materials reviewed may include flyers, brochures, trifolds, text messages, member notices, the Annual Notice of Change, Enrollment Request Forms, Summaries of Benefits, Evidence of Coverage documents, and more. These materials serve various purposes, including outreach, potential enrollment activities, and educating current members about the services offered.           

This role primarily operates remotely with in-office presence only as needed for key meetings, collaboration, or business needs.

Job Description

• Conducts detailed review of member and prospective member communications against CMS regulations to ensure compliance and provides professional feedback to material owners
• Analyze all Medicare and MAP related marketing materials for compliance with CMS Marketing guidelines
• Submit all needed materials to CMS for review and approval via HPMS
• Maintain up-to-date knowledge of all Centers of Medicare & Medicaid (CMS) regulations
• Collaborate with the Product team to ensure the accuracy of benefit information and clarity of language 
• Partner with operational business units to support the creation, submission, and approval of marketing materials during the Annual Enrollment Period (AEP)
• Collaborate closely with the Regulatory Materials Reviewer on communications related to IB-Duals Group and MAP.
• Assist in maintaining a comprehensive repository of all material reviews, including documentation of review and inquiry responses within the SharePoint site, and saving copies of all relevant documents and communications.
• Assign final codes to all materials reviewed and approved internally and externally by CMS.
• Other duties and responsibilities as assigned by the Regulatory Operations Manager.

Requirements

• Bachelor’s Degree required.
• 5 years’ of Managed Care experience, with a focus on Medicare and Integrated Programs required.
• A satisfactory equivalency in education, training, and experience.
• Experience with Medicare and CMS Regulations required.
• Experience with the creation, submission and approval of CMS marketing materials.
• Experience managing multiple requests and keeping track of incoming requests and tracking deadlines.
• Team player, willing to collaborate and provide guidance to cross-functional teams.
• Ability to manager multiple projects under tight deadlines and strong attention to deal. 
• Proficiency in Microsoft Suite, including SharePoint.