Medicare Analyst Job in Frisco 75034, Texas Us
About the Job
Catalyst Health Solutions, Inc (formerly HealthExtras, Inc.) is built on strong, innovative principles in the management of prescription drug benefits and provides an unbiased, client-centered philosophy resulting in a year-over-year client retention rate of more than 98%. The Company's subsidiaries include Catalyst Rx, a full-service pharmacy benefit manager (PBM) serving more than five million lives in the United States and Puerto Rico; HospiScript Services, LLC, one of the largest providers of pharmacy benefit management services to the hospice industry; and Immediate Pharmaceutical Service, Inc., a fully-integrated prescription mail service facility based out of Avon Lake, Ohio. The company also offers Medicare Part D and Workers Compensation PBM services. Its clients include self-insured employers including state and local goverments, managed care organizations, unions, hospices, third-party adminstirators and individuals.
Position Description:
-Responsible for auditing Medicare processes to ensure operational compliance using statistically valid sample populations and knowledge of Medicare regulations.
-Provides meaningful feedback on audit results and quantifies risks to Medicare client services team.
-Effectively communicates with various levels of the organization to ensure operational execution is aligned with business requirements.
-Establishes solid relationships with key CatalystRx operational and business unit leaders.
-Identifies improvement opportunities and leads improvement projects.
-Creates and delivers meaningful reporting as necessary to support pharmacy analytics or business needs.
-Provides recommendations to management for future areas of review.
-Performing other duties, as necessary, to meet corporate objectives.
-Travel up to 20%.
To Apply Visit Catalyst Health Solutions, Inc.
Qualifications:
Bachelor’s Degree or equivalent work experience required with a preference for PMP, Six Sigma, and/or American Society for Quality certification. Qualified candidates should have demonstrated experience in data interpretation and analytics, knowledge of reporting and query tools, with a background in operations, compliance, or auditing. Knowledge of Medicare Part D regulations and requirements is preferred. Candidates must possess the ability to build solid relationships to ensure a strong, cohesive business relationship is established and maintained. Must exhibit accurate and solid judgment in handling complex and interpersonal issues and be an effective communicator with strong presentation skills, creativity, analytic abilities, and be capable of influencing positive change through combined networking strength and data interpretation.