Medicare Regulatory Analyst

HCSC is a leading health services organization with a commitment to employee growth and development, and we are looking for a dedicated professional to join our team as a CMS MA-PD and PDP Escalated Complaints Coordinator. Job Summary This position is responsible for receipt and coordination of CMS MA-PD and PDP escalated complaints; submission of member and marketing materials to CMS for HCSC’s Medicare Advantage and Prescription Drug Plans; applying CMS regulations pertaining to Medicare Advantage and Prescription Drug Plans to the review of member and marketing materials prior to submission to CMS; providing assistance and guidance regarding Medicare Advantage and Prescription Drug Plan regulations to HISC staff; working with other areas of the organization on the development, testing and implementation of organization, process and system changes to ensure the requirements of the Medicare Advantage and Prescription Drug program are met; and assisting MCO in coordination of the contract with CMS enterprise‑wide. Job Requirements Bachelor’s degree in business OR 2 years’ experience with health insurance. 1 year of experience with health insurance benefits and/or operations. Knowledge of Medicare advantage 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 including Microsoft Word, Excel, PowerPoint, and Lotus Notes. Preferred Job Requirements Knowledge of CMS Medicare Advantage software applications, Medicare Advantage and Prescription Drug Plan coverage including Regulations and Guidelines. CTM experience (Complaint Tracking Module). Knowledge of health benefits. Compensation & Benefits Base Pay Range: $41,700.00 - $92,800.00. Exact compensation may vary based on skills, experience, and location. This role aligns with an annual incentive bonus plan subject to terms and conditions. You will receive a robust total rewards package, including health and wellness benefits, a 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, and other incentives. Equal Employment Opportunity 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. #J-18808-Ljbffr Health Care Service Corporation