MedCareD Compliance Specialist

2 weeks ago

Troy, United States Henry Ford Health System Full time

GENERAL SUMMARY:The Medicare Part D Compliance Specialist oversees the HAP Part D program to assure that the program meets all CMS compliance requirements with the goal of achieving best practices. Critical components include oversight of PBM set-up, review and interpretation of new regulatory requirements and monitoring of internal departmental processes and procedures. This position also plays a key role in assuring successful audit results by conducting pre-audit reviews and preparation for actual audits. EDUCATION AND EXPERIENCE:Requires high school diploma; 3 years of Medicare Part D experience; 5 years of experience in Rx benefit design, pharmacy claims processing systems and PBM set-up; in-depth knowledge of Medicare regulations; exemplary oral and written communication skills; ability to use office productivity software effectively; and ability to create and work with complex Excel spreadsheets and Access databases. Additional Information + Organization: Community Care Services + Department: Pharmacy-Utilization Mgmt + Shift: Day Job + Union Code: Not Applicable Additional Details This posting represents the major duties, responsibilities, and authorities of this job, and is not intended to be a complete list of all tasks and functions. It should be understood, therefore, that incumbents may be asked to perform job-related duties beyond those explicitly described above. Overview Partnering with nearly 2 million people on their health journey, Henry Ford Health provides a full continuum of services at 250 care locations throughout southeast and south central Michigan. With 33,000 valued team members, Henry Ford is also among Michigan's largest and most diverse employers. Our superior care and discoveries are powered by nearly 6,000 physicians, researchers and advanced practice providers. Learn more athenryford.com. Benefits Whether it's offering a new medical option, helping you make healthier lifestyle choices or making the employee enrollment selection experience easier, it's all about choice. Henry Ford Health has a new approach for its employee benefits program - My Choice Rewards. My Choice Rewards is a program as diverse as the people it serves. There are dozens of options for all of our employees including compensation, benefits, work/life balance and learning - options that enhance your career and add value to your personal life. As an employee you are provided access to Retirement Programs, an Employee Assistance Program (Henry Ford Enhanced), Tuition Reimbursement, Paid Time Off, Employee Health and Wellness, and a whole host of other benefits and services. Employee's classified as contingent status are not eligible for benefits. Equal Employment Opportunity/Affirmative Action Employer Equal Employment Opportunity / Affirmative Action Employer Henry Ford Health is committed to the hiring, advancement and fair treatment of all individuals without regard to race, color, creed, religion, age, sex, national origin, disability, veteran status, size, height, weight, marital status, family status, gender identity, sexual orientation, and genetic information, or any other protected status in accordance with applicable federal and state laws.

  • MedCareD Compliance Specialist

    5 days ago

    Troy, Michigan, United States The Henry Ford Health System Full time

    We are looking for a Medicare Part D Compliance Specialist! The main responsibility of the Compliance Specialist is to supervise the HAP Part D program, ensuring that it complies with all CMS requirements and aiming to reach best practices. Key elements of the role involve managing PBM set-up, assessing and inte Compliance Specialist, Management,...

  • MedCareD Compliance Specialist

    5 days ago

    Troy, Michigan, United States Henry Ford Health System Full time

    GENERAL SUMMARY:The Medicare Part D Compliance Specialist oversees the HAP Part D program to assure that the program meets all CMS compliance requirements with the goal of achieving best practices. Critical components include oversight of PBM set-up, review and interpretation of new regulatory requirements and monitoring of internal departmental processes...

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    3 weeks ago

    Troy, United States The Henry Ford Health System Full time

    The Medicare Part D Compliance Specialist oversees the HAP Part D program to assure that the program meets all CMS compliance requirements with the goal of achieving best practices. Critical components include oversight of PBM set-up, review and inte Compliance Specialist, Management, Compliance, Specialist, Healthcare

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