Area Vice President, Medicare, National Pharmacy Practice

Overview

This position manages key client projects for Medicare Advantage Prescription Drug and Employer Group Waiver Plans. Responsibilities include the accurate development and review for accuracy of Medicare required member materials such as the annual notice of change (ANOC) and evidence of coverage (EOC). In addition to communications, ongoing client management of key clients will be expected.

• Use existing strong understanding of employee benefits regulations, vendor products and capabilities to solve client issues in a timely manner.
• Attend internal training sessions as well as industry related sessions to enhance knowledge and to develop professionally.
• Prioritize responsiveness to Clients, Senior Pharmacy Consultants and Health and Welfare Producers.
• Proactively communicate with Team Members, Clients, Carriers and Vendors
• Material Development:
  Accurately draft, develop or peer review Medicare-required member materials, including ANOC and EOC, ensuring compliance with CMS guidelines customizing to client requirements. This would include making edits and recommendations based on Medicare rules, creating client specific timelines and back-and-forth customization with our clients to ensure compliance.
• Material Review:
  Conduct thorough reviews of member materials to verify accuracy, consistency, and adherence to regulatory requirements.
• Project Management:
  Manage multiple client projects simultaneously, ensuring timely delivery of high-quality materials.
• Compliance Assurance:
  Stay updated on Medicare regulations and guidelines to ensure all materials meet current standards.
• Client
  
  Collaboration:
  
  Work closely with clients to understand their needs, provide updates, and address any concerns related to member materials.
• Quality Control:
  Implement quality assurance processes to identify and correct errors in documentation.
• Support Senior pharmacy benefits consultants and producers in client facing activities and revenue generating opportunities
• Maintain technical understanding of pharmacy benefit products and concepts
• Have a strong understanding of current pharmacy benefit trends, conditions and concepts.
• Be capable of reviewing and interpreting CMS marketing requirements, explaining utilization and cost trends to existing or prospective clients.
• Establish and maintain proactive communication with clients/carriers and vendors
• Keep a current awareness of vendors’ products and capabilities
• Keep Senior Pharmacy Consultant informed on matters of importance via written and verbal correspondence
• Advise on and contribute to creation of content for employee communication material specific to required Medicare changes annually to be used by a client regarding employee benefit design and cost if requested
• Respond to all client questions regarding, member materials, and facilitate resolution of complex issues in a timely manner as needed
• Stay abreast of all client pharmacy activity, including renewals, market checks, procurement activity and audit opportunities.
• Interface with team members and servicing team on issues relating to the client
• Maintain client files with documentation as required by internal compliance standards
• Participate in special projects as assigned; perform other duties as assigned by management
• Participate in client facing meetings and calls, as needed
• Create member webinar presentation for Clients to present new Medicare benefit implementations
• Ensure that clients requirements and needs are represented to our vendors not only for member materials, but to also avoid the need to be forced into vendor standard offerings

Required: Bachelor 's degree and at least 10 years of Medicare Compliance/Communications experience

• Must be self-motivated, assertive, enthusiastic and collaborative
• Must be amiable when encountering difficult situations with clients, vendors and co-workers
• Must be well organized with the ability to prioritize effectively and deliver work according to strict deadlines
• Must be an excellent verbal and written communicator. Should be comfortable with making presentations to peers and to clients
• Must have excellent technical skills and knowledge of business…