Consultant: Medicare Subject Matter Expert
Responsible for providing subject matter expertise on Medicare to effectively support our clients, as well as, managing the day to day responsibilities of project management.
Medicare Subject Matter Expert:
- Provide subject matter expertise in designated areas of expertise
- Provide review, interpretation and implementation of state and federal guidance
- Perform CMS mock audits areas of specialty
- Perform operational remediation in areas of specialty
- Mentor and drive work product based on the project scope of work
- Develop, review for quality and coordinate all deliverables
- Oversee and administer ongoing monitoring program(s) based on CMS guidance
- Updates policies, procedures and project work plans as needed.
- Adhere to established corporate policies and procedures
- Perform other duties, as necessary, to meet corporate objectives
- Travel as required
- Assist BluePeak Operations in scheduling BluePeak resources to meet client demand and balance workload.
- Coordinate and collaborate with Project/Audit standardization committee for implementing audit or project management changes and/or templates.
- Bachelor’s degree and a minimum of five (5) years government, health care, pharmacy benefit management, compliance or quality profession (equivalent combination of education and experience considered.): Required
- Must have strong Microsoft Office Suite skills. Advanced skills in Word, Excel, Access and PowerPoint: Required
- Experience with Medicare and/or Medicaid regulations and guidance: Required
- Advanced degree or certification in audit, pharmacy or compliance discipline: Preferred
- Prior project management training and/or experience: Preferred
- Must have strong verbal and written communication skills.
- Individual should be detail oriented with strong organization, prioritization and analytical skills with the ability to work independently.
- Must work well under tight timelines and adapt quickly to change in a fast-paced, team-oriented, and high-growth environment.