EGWP & Medicare Part D Programs Manager

Socket.dev; Charlotte (NC); Hybrid; USD 107,000 - 134,000; Full time

Job summary

Judi Health in Charlotte, NC is seeking an EGWP Manager to implement and oversee regulatory requirements for the Health Plan EGWP line. You will manage daily activities across claims processing, clinical programs, and CMS oversight to meet regulatory and financial objectives.

Ideal candidates have 5+ years in Medicare Part D/EGWP, strong regulatory and operational acumen, and experience in matrixed organizations.

Qualifications

• Minimum of HS diploma/GED or equivalent experience.
• 5+ years of Medicare Part D and/or EGWP experience.
• Deep knowledge of Medicare Part D claim processing requirements, CDAG oversight and monitoring, and Health Plan Part D reporting.
• Experience in a delegated and highly matrixed organization.

Responsibilities

• Manage EGWP program setup, implementation and go-live readiness across functions.
• Provide day to day management to operations analyst EGWP.
• Oversee financial performance, KPIs and CMS compliance metrics for PBM claims and related processes.
• Lead regulatory reporting to ensure timely and accurate disclosures.

Education

HS diploma/GED or equivalent

Tools

HPMS

MARx

Job description

Judi Health in Charlotte, NC is seeking an EGWP Manager to implement and oversee regulatory requirements for the Health Plan EGWP line. You will manage daily activities across claims processing, clinical programs, and CMS oversight to meet regulatory and financial objectives.

Ideal candidates have 5+ years in Medicare Part D/EGWP, strong regulatory and operational acumen, and experience in matrixed organizations.