Job Description

This position will require being on-site 1 day a week, in either the Chicago or Washington, DC office. This position will support the Part D Medicare Compliance Officer. Preference will be given to candidates with experience in Medicare Programs. Designs and documents business process requirements for all related business, financial, and operational systems critical to core business functions within FEP for support of the Medicare Prescription Drug Program, and other Medicare programs. This may require the Business Analyst to research and analyze data in support of business functions, process knowledge, and systems requirements. Recommends new or improvements to existing business and operational processes and procedures. Manages projects to build a Medicare Compliance Program. Manages compliance program auditing and monitoring activities. Assists with audit readiness. This person should have 7 years’ experience in the health payer industry – Blues or FEHBP experience desirable. Experience in Medicare Program Audits or Medicare CPE Audits is desirable. Experience with Compliance Programs is preferred. Key Responsibilities Auditing and monitoring compliance program Monthly exclusion check monitoring Updating policies and procedures Compliance program communications Compliance committee meetings Compliance program workplan HPMS memo review and analysis Compliance program liaison with FEP Medicare Compliance shared mailbox owner Attend monthly MAPD Plan calls Assist with Compliance Program audit readiness Seniority Level Mid-Senior level Employment Type Contract Job Function Legal Industries Software Development #J-18808-Ljbffr Adroitts

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