Medicare Part D Coordinator: Compliance & Reporting Lead

CMP01 Mount Sinai Medical Center of Florida, Inc.; United States; On-site; USD 70,000 - 95,000; Full time

Benefits offered by this job

Health benefits

Life insurance

Long-term disability

Retirement plan

Paid time off

Tuition reimbursement

Employee assistance program

Wellness program

On-site housing for select positions

Job summary

Mount Sinai Medical Center of Florida, Inc. seeks a Medicare Part D Compliance professional for Eldercare. The role oversees PDE reporting, Part D-related activities, rebates, and compliance programs, coordinating with accounting and third parties.

The candidate should have 2+ years in Medicare health plans or Part D operations, and a health care compliance certification is highly preferred. This position supports audits, renewals, and quality initiatives within a large Florida hospital system.

Qualifications

• Health care compliance certification is highly preferred.
• Bachelor's Degree is preferred.
• At least 2 years of experience in a Medicare health plan, Pharmacy Benefit Manager or Part D Actuary.
• Experience in Part D program operations and/or compliance is extremely helpful.
• Experience in compliance and Fraud, Waste and Abuse programs as well as experience with a PBM is preferred.

Responsibilities

• Serve as the point person for all Part D related activities at Eldercare.
• Support the annual Part D bid by tracking expenses and coordinating with accounting and bid prep.
• Oversee PDE reporting and related processes.
• Oversee drug rebate and manufacturer discount reporting.
• Oversee Plan to Plan payment reporting.
• Coordinate Part D reporting to third parties and Medicare.
• Support the organization’s compliance and Fraud, Waste and Abuse program.
• Track licenses and renewals to ensure compliance.
• Manage insurance renewals including emergency management plans.
• Conduct compliance audits and report findings to Executive Director.
• Handle Eldercare Accounts Payable including check requests and invoices.
• Backup enrollment, claims, network and HR tasks as needed.
• Communicate with management on projects/issues.
• Complete assignments accurately and timely.
• Align with Eldercare philosophy and goals.
• Participate in Quality Improvement initiatives.

Skills

Medicare Part D experience

Health care compliance

Compliance programs

Education

Bachelor's degree

Job description

Mount Sinai Medical Center of Florida, Inc. seeks a Medicare Part D Compliance professional for Eldercare. The role oversees PDE reporting, Part D-related activities, rebates, and compliance programs, coordinating with accounting and third parties.

The candidate should have 2+ years in Medicare health plans or Part D operations, and a health care compliance certification is highly preferred. This position supports audits, renewals, and quality initiatives within a large Florida hospital system.