Medicare Part D & Compliance Coordinator

Mount Sinai Medical Center; Florida; Presencial; USD 70.000 - 95.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health benefits

Life insurance

Retirement plan

Paid time off

Tuition reimbursement

Employee assistance program

Wellness program

On-site housing for select positions

Descripción de la vacante

Mount Sinai Medical Center invites applications for a role focused on Medicare Part D operations and compliance within Eldercare. You will manage PDE reporting, bid support, rebates, and third-party submissions while ensuring Fraud, Waste and Abuse controls are in place.

Responsibilities include license tracking, renewals, and coordination with accounting for AP while supporting enrollment, claims, and HR tasks as needed. Bachelor’s preferred; health-care compliance experience highly valued.

Formación

• Health Care Compliance certification highly preferred.
• Bachelor's Degree is preferred.
• At least 2 years prior experience in a Medicare health plan, Pharmacy Benefit Manager or Part D Actuary is desirable.

Responsabilidades

• Serve as the point person for all Medicare Part D activities at Eldercare.
• Support the annual Part D bid with records of pharmacy expenses and bid tracking.
• Responsible for PDE reporting and oversight.
• Responsible for drug rebate and manufacturer discount reporting.
• Handle Plan to Plan payment reporting and oversight.
• Coordinate Part D reporting to third parties and Medicare (e.g., Acumen, HPMS).
• Oversee the organization’s compliance and Fraud, Waste and Abuse program.
• Track licensures and renewals to ensure compliance.
• Manage insurance renewals including emergency management plans and renewals.
• Conduct compliance audits and report findings to leadership.
• Process Eldercare Accounts Payable and approve invoices.
• Back up enrollment, claims, network and HR tasks.
• Maintain communication with management on projects and issues.
• Adhere to Eldercare philosophy and participate in Quality Improvement.

Conocimientos

Medicare Part D

PDE reporting

Compliance program

Educación

Bachelor's degree preferred

Descripción del empleo

Mount Sinai Medical Center invites applications for a role focused on Medicare Part D operations and compliance within Eldercare. You will manage PDE reporting, bid support, rebates, and third-party submissions while ensuring Fraud, Waste and Abuse controls are in place.

Responsibilities include license tracking, renewals, and coordination with accounting for AP while supporting enrollment, claims, and HR tasks as needed. Bachelor’s preferred; health-care compliance experience highly valued.