Sr Medicare Regulatory Analyst - WFH

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

Basic Function

Responsible for investigating and resolving high-profile Medicare Part D complaints and grievances, ensuring CMS regulatory compliance, supporting audit activities, managing drug recall communications, coordinating emergency access-to-benefits processes, and partnering across departments to implement operational and system improvements.

Required Job Qualifications

• *Bachelor Degree in Business OR 3 years experience with health insurance.
• *2 years experience with health insurance benefits and/or operations.
• *Knowledge of Medicare Part D product
• *Verbal and written communication skills.
• *Ability to present Medicare trends and findings in meetings with management.
• *Ability to organize multiple tasks and responsibilities.
• *Ability to analyze data reports.
• *Experience developing and running queries in a database.
• *PC proficiency to include Microsoft Word, Excel, PowerPoint and Outlook

Preferred Job Qualifications

• *Knowledge of CMS software application MARx.
• *Prescription Drug coverage and knowledge of CMS Part D Regulations and Guidelines.
• *Knowledge of Prescription Drug benefits as well as Retail or other Pharmacy operations
• Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards .

The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan.

HCSC Employment Statement

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

Base Pay Range

• $55,900.00 - $123,500.00
• Exact compensation may vary based on skills, experience, and location.