Ensures MVP compliance with all Centers for Medicare and Medicaid (CMS) enrollment related guidelines. This is completed in a variety of methods, including: analysis of department performance, continual review for CMS compliance, providing direction for day to day prioritization of work to ensure effective and appropriate handling of all Medicare related enrollment activities, managing the interpretation and implementation of CMS changes. Works with department management to coordinate completion of work while adhering to CMS standards. Assessment of policy and procedure to ensure department processes are within CMS regulations. Implements Medicare rules and regulations as they relate to the Enrollment department. Represents enrollment in Medicare related projects, meetings and/or CMS conferences. Performs quarterly audits of enrollment processes in accordance to CMS auditing guidelines, documents and provides results to the Medicare Compliance Committee. Manage CMS reporting and monitoring programs, coordinates internal and external audits. Maintain relationship with CMS regional account manager for assistance in CMS guidance clarification. Performs other projects/duties as assigned.
Minimum Education: BA/BS preferred.
Minimum Experience: Experience in an Analytical/Process Improvement role required. 4 years experience preferred. Experience and knowledge in working with CMS regulations and requirements related to Medicare Advantage/Part D plan enrollment.
" 2 years Medicare Knowledge.
" Experience or knowledge with interpreting/implementing regulatory requirements.
" Experience monitoring and evaluating performance of operational activities is required
" Strong organizational skills
" Detail oriented
" Self motivated, required
" Strong meeting facilitating and presentation skills
" Ability to occasionally travel overnight or locally
" Strong computer knowledge (Excel and Word) required.
" Project management experience.
" Microsoft access and project.
MVP Health Plan covers about 650,000 most valuable people. Also known as MVP Health Care, the company provides health insurance and employee...