Salary
💰 $59,500 - $80,500 per year
About the role
- Conduct intake, analysis and resolution tracking of complaints related to the Medicare Drug Price Negotiation Program
- Review complaint and dispute data, categorize issues, prioritize cases based on severity, and ensure accurate documentation of each complaint’s lifecycle
- Work closely with cross-functional teams to capture data necessary for analysis of complaints, identify trends, and recommend process improvements to enhance service delivery
- Collaborate with senior team members on referrals to the investigative team
- Use critical thinking to understand program rules and make informed decisions related to disposition and adjudication of complaints
- Maintain confidentiality and adhere to HIPPA and CMS data protection requirements
- Support CMS by consistently and accurately addressing stakeholder complaints and disputes related to the Program
Requirements
- Bachelor’s Degree (or equivalent experience)
- At least 5 years of healthcare experience
- 5+ years of related experience
- Proficiency using Microsoft Office product suite
- Skills: Analytical Thinking, Collaborating, Microsoft Office, Problem Solving, Written Communication
- Knowledge of federal healthcare regulations (desired)
- Experience evaluating healthcare data including prescription drug claims (desired)
- Maintain confidentiality and adhere to HIPPA and CMS data protection requirements
- Public Trust/Other Required: NACI (T1)
- US Citizenship Required: No