Director of Partnerships and Implementation
Kooth plc
Manager, Medicare Program Services, Med D
CVS Health
full-time
Posted on:
Origin: • 🇺🇸 United States • Arizona
Visit company websiteSalary
💰 $60,300 - $132,600 per year
Job Level
Mid-LevelSenior
About the role
- As an Audit and Testing Program manager, provide technical, analytical, and business support for Medicare, Medicaid, and Commercial products including ESRD, Hospice, Transplant, Transition Fill and Part D Vaccine Administration. Support CMS program audits by delivering information in advance and communicate implications for successful audit experience. Research claims, read benefit setups in RxClaim, articulate risks or concerns, and manage deliverables from audit activities including corrective action plans, issue narratives, and talking papers. Speak to Med D compliance and reporting documentation associated with clinical programs; develop IT query writing and data analysis, business impact analysis, and root cause analysis. Present claims in RxClaim via live webinars with CMS and clients; conduct year-round quality assurance testing and validate functionality for internal and external partners to ensure smooth go-live for new clients.
Requirements
- 3+ years of Pharmacy Benefit Management, Medicare Part D or Medicaid experience 2+ years of in-depth knowledge of pharmacy products, services, and system capabilities 1+ years of project management or business analyst experience including the management of complex requirements 1+ Experience with the RxClaim software system Developing IT query writing and data analysis, business impact analysis; and root cause analysis Ability to interact with various levels of an organization, including senior leadership Prepare and deliver presentations to clients Analyze large data files to find root cause Travel for business support less than 20% of the year Be vaccinated for COVID-19 Attention to detail and accuracy Highly organized and able to quickly prioritize multiple assignments Exercise creativity and innovation in achieving project results
