Analyst, Tech. Operations Government Programs
$43,780–$43,780 year
RemoteHawaii, United States or South Carolina, United States
Job Summary
Execute Government Programs processes accurately, efficiently, and in compliance with CMS regulations, including Employer Group Waiver Plan enrollment, retro-eligibility, financial reporting, and claim auditing. Oversee assigned process schedules to ensure deadlines are met and alert management when risks arise. Maintain accurate process documentation and assist subject matter experts in defining technical specifications. Review errors, prioritize reconciliation efforts per State and Federal guidance, and communicate with Employer Groups, clients, agencies, and vendors to resolve issues. Work outside normal hours as needed for time-sensitive tasks.
Required Qualifications
- Bachelor/Associate Degree in business related field; or equivalent of an associate degree and 2 years of work experience, or 4 years of work experience and a high school diploma or equivalent
- 1+ years' work experience
- The ability to consistently interact cooperatively and respectfully with other employees
- Must be able to work outside of normal business hours to complete time sensitive processes
Desired Qualifications
- Experience in pharmaceutical claims adjudication systems, retail pharmacy, or in a health plan organization is preferred
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