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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
compliance training tracking
auditing and monitoring compliance program
monthly exclusion check monitoring
updating policies and procedures
compliance hotline monitoring
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
Ability to Commute:
North Chicago, IL 60064 (Required)
Ability to Relocate:
North Chicago, IL 60064: Relocate before starting work (Preferred)
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Worksite address
chicago, IL, 60290, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.