Supervisor, Government Programs

We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration.

The Supervisor, Government Programs, will be responsible for oversight of the day-to-day function of the Government Programs team. The Supervisor will be responsible for monitoring, reporting and compliance support activities, as well as the review, interpretation and documentation of regulations and requirements pertaining to the benefit designs and system maintenance for Medicare and particularly Employer Group Waiver Plan (EGWP) Prescription Drug Plans (PDPs); and the creation of corresponding documentation, policies and procedures. Overtime and holiday work may be required.

• Associate's degree required. Bachelor's degree preferred. An additional two (2) years of experience will be considered in lieu of degree.

• Four (4) years of experience in Medicare operations (enrollment, benefit administration, and/or claims payment/reimbursement methodology) required. EGWP PDP administration preferred.

• One (1) year of progressive leadership/management responsibilities required.

• Experience processing online Medicare Part D claims or implementing government policy related to Medicare/Medicaid, including regulatory compliance in benefit implementation, formulary administration, pharmacy claim adjudication, regulatory reporting (e.g., PDE, EOB files), and/or audit processes required.

• Strong analytical, problem solving, time management and organizational skills.

• Strong interpersonal skills and ability to interact with clients and vendors.

• Advanced computer, Windows and MS Office skills required.

• Experience in interpreting reports and other system output to support decision making and information dissemination.

• Proven examples of displaying the PBD values: Trusted Advisor, Innovative, Excellence, Guardianship, Dedication and Caring.

• Oversee daily operations of government programs team members who are responsible for monitoring and maintaining systems and processes to ensure accuracy and consistency for system, benefit, formulary and claims administration, eligibility, file/reporting transfers and compliance support for Medicare Part D Plans.

• Coach and mentor staff to achieve departmental and organizational goals and objectives. Conduct regular one-on-one meetings with direct reports to build more effective communications, understand associate needs and provide direction, insight and feedback. Provide timely feedback to senior management regarding team performance.

• Responsible for maintaining an understanding of the various regulations and requirements for PBM lines of business, including but not limited to Medicare Part D and EGWP/PDP; including review and interpretation of new guidance, memos, and/or regulations.

• Oversee, create and maintain policies and procedures and other documentation specific to PBD operations. Coordinate and work with the PBD Programs Trainer to identify and develop needs-based training for all associates.

• Coordinate, maintain and deliver regulatory Medicare Part D reporting specific to the Pharmacy Department such as internal/external audits and timeliness tracking for manual member reimbursements.

Immigration or work visa sponsorship will not be provided for this position

Hiring Compensation Range: $62,500 - $67,500 annually

Compensation may vary based on factors including but not limited to skills, education, location and experience.

In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future.

As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant's race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law. Click here for additional EEO/AAP or Reasonable Accommodation information.

Current Associates must apply internally via the Job Hub app.