The senior Medicare process specialist will perform the following activities, among others:
Serve as primary liaison with client health plans and internal development and compliance teams to ensure effective two-way communication, promote understanding of system functionality and encourage cross-functional cooperation
Gather client business requirements and assess progress toward achieving deployment goals
Remain current in knowledge of Medicare regulations by reading, interpreting and analyzing regulatory bulletins, memos and other updates
Develop and implement efficient and functional system design documents based on client requests or regulatory changes
Serve as a subject matter expert regarding Medicare regulations and operational procedures
At least 2 years of recent experience in enrollment/membership operations or regulatory compliance in a Medicare Advantage health plan, with specific knowledge of the Medicare Managed Care Manual Chapter 2 and/or Prescription Drug Benefit Manual Chapters 3 and 4
Bachelors degree required, MBA preferred
Experience with business analysis and process improvement (necessary for success), and IT background strongly preferred
Excellent communication skills (both written and verbal)
Competitive salary. To apply for this position, please click here .
Or be sure to reference the specific job title (and code, if relevant) and mail a copy to:
134 Turnpike Road
Southborough, MA 01772
ikaSystems Corporation - 3 years ago
ikaSystems plays a leading role in the exciting transformation of the healthcare industry by delivering advanced business technology to...