Medicare Part D Compliance & Program Coordinator

Mount Sinai Medical Center; Florida; On-site; USD 65,000 - 95,000; Full time

Benefits offered by this job

Health benefits

Life insurance

Long-term disability coverage

Retirement plan

Paid time off

Tuition reimbursement

Employee assistance program

Wellness program

On-site housing for select positions

Job summary

Mount Sinai Medical Center is seeking a qualified professional to manage Medicare Part D activities within Eldercare. The role focuses on PDE reporting, drug rebates, and Plan to Plan payments, ensuring compliance with Medicare requirements and third-party reporting requirements.

You will support annual Part D bids, maintain accurate expense records, and collaborate with accounting and management to drive continuous improvement and ensure regulatory alignment across departments.

Qualifications

• Bachelor's degree required or preferred.
• Minimum 2 years experience in Medicare health plan, PBM, or Part D Actuary.
• Experience in Part D program operations or compliance is a strong plus.
• Experience with Fraud, Waste and Abuse programs is preferred.

Responsibilities

• Serve as the point person for all Medicare Part D activities at Eldercare.
• Maintain records of all pharmacy expenses and bid tracking for Part D bids.
• Oversee PDE reporting and related compliance activities.
• Oversee drug rebate reporting and manufacturer discounts.
• Handle Plan to Plan payment reporting and oversight.
• Coordinate Part D reporting to third parties and Medicare (Acumen, HPMS, Pharmastar, Milliman, Palmetto).
• Support compliance programs including Fraud, Waste and Abuse with data gathering and reporting.
• Track licenses and renewal applications to ensure ongoing compliance.
• Manage insurance renewals and emergency management plan renewals to keep coverage active.
• Conduct compliance audits and report findings to the Executive Director.

Education

Bachelor's Degree

Job description

Mount Sinai Medical Center is seeking a qualified professional to manage Medicare Part D activities within Eldercare. The role focuses on PDE reporting, drug rebates, and Plan to Plan payments, ensuring compliance with Medicare requirements and third-party reporting requirements.

You will support annual Part D bids, maintain accurate expense records, and collaborate with accounting and management to drive continuous improvement and ensure regulatory alignment across departments.