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Medicare Reporting Analyst
2 months ago
We are seeking a Medicare Programs Report Specialist for a hybrid work opportunity, primarily remote. This role is essential for the analysis and audit of data provided by our business partners, ensuring compliance with the Centers for Medicare & Medicaid Services (CMS) mandatory reporting requirements.
Our Commitment to Diversity
At Presbyterian, we celebrate the unique differences of our employees and recognize that diversity strengthens our team and community.
Why Consider This Opportunity?
- Full-Time Position
- Located at Rev Hugh Cooper Admin Center
- Standard Work Hours: Monday to Friday
- Comprehensive Benefits Package: Includes medical, wellness programs, vision, dental, paid time off, retirement plans, and more for full-time employees.
- High School Diploma or GED required.
- 1-3 years of experience in data compilation for CMS reporting, utilizing various technological tools and analytical software.
- Proficiency in MS Office Suite, Business Objects, Facets, SharePoint, and Support Point.
- Preferred background in health plans or Medicare Advantage plans; familiarity with the CMS Health Plan Management System (HPMS) is advantageous.
- Strong analytical skills with the ability to interpret data and solve problems independently or collaboratively.
- Effective communication skills, both verbal and written, with the ability to negotiate and reach consensus.
- Demonstrated time management abilities, capable of multitasking and adapting to changing priorities.
- Ensure timely submission of required reports and marketing materials to CMS, adhering to regulatory standards.
- Maintain operational compliance with CMS regulations through a structured reporting matrix.
- Review and submit reports as mandated by CMS.
- Generate and upload enrollment eligibility files and various reports for key stakeholders, maintaining regular communication.
- Act as a liaison during the health plan's annual external data validation audit, compiling necessary documentation and updating reporting specifications.
- Follow internal document review processes and manage submissions of marketing and non-marketing materials to CMS.
- Oversee the submission of Medicare Advantage member materials, including enrollment and educational documents.
- Track communication documents to ensure standardized protocols are followed by all stakeholders.
- Assist in the preparation and submission of new product applications and annual renewal cycle documents.
- Support the development and revision of departmental policies and procedures as needed.
- Identify opportunities for internal improvements to enhance efficiency and customer experience.
- Collaborate with Government Program Medicaid and Education/Outreach teams as directed.
Presbyterian offers a comprehensive benefits package for eligible employees, including medical, dental, vision, short-term and long-term disability, and life insurance options.
Wellness Initiatives
Our Employee Wellness rewards program encourages active participation in health-enhancing activities, offering incentives such as gift cards for engagement in wellness challenges and preventive screenings.
About Presbyterian Healthcare Services
Presbyterian is dedicated to improving the health of our patients, members, and communities. As a locally owned, not-for-profit healthcare system, we operate nine hospitals and a statewide health plan, employing nearly 14,000 individuals.
Our health plan serves over 580,000 members statewide, offering Medicare Advantage, Medicaid, and Commercial health plans.
Inclusion and Diversity
We foster a culture of respect and understanding among our patients, members, and employees, reflected in our organizational commitments.
AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke-free campuses.
CompensationThe maximum offer for this position is up to USD $32.17 per hour.
Compensation DisclaimerThe compensation range for this role considers various factors, including experience, training, internal equity, and organizational needs.
