Medicare Policy SME
Remote, Anywhere in the US. Immediate Hire
Rainmakers Strategic Solutions LLC is a fast growing, high performing business delivering value-added consulting services that enable our clients to envision, implement and measure achievement of their transformational and strategic goals. We are committed to Excellence, Passion, Diversity and Knowledge. Rainmakers offers comprehensive benefits and highly competitive compensation packages.
Key Duties/Responsibilities of the Medicare Policy SME
- Serves as a Medicare benefits senior advisor to customer’s executive management team in a variety of capacities
- Key responsibilities include:
- Maintain knowledge and subject matter expertise through continuous review of Medicare and/or Marketplace policies, procedures, publications, training materials, training sessions
- Review and analyze information obtained from multiple governmental, legislative, and regulatory sources for impact on Content and Training products. Research, review, revise, and validate training and content materials and artifacts ensuring compliance with Medicare policies, procedures, and related call center operation’s procedures and technologies
- For Marketplace: Analyze health policy and provide strategic health communication to support ACA Marketplace customer service representatives (CSRs)
- Bachelor’s Degree in Business Management or Administration
Position Requirements and Relevant Knowledge
- Must have ability to explain Medicare and/or Marketplace specific concepts to an audience lacking familiarity with such concepts
- Ability to participate in call listening activities to synthesize information
- Experience working at CMS desired
- Minimum 8 years’ experience supporting Medicare programs (state or federal)
- Experience working with insurance plans a plus
Environment and Cognitive/Physical Demands
- Teleworking, virtual work environment
- Ability to read, keyboard, reason, communicate effectively and problem solve
- Requires prolonged sitting and telephone use
- Requires the use of office equipment such as computer terminals, telephones, copiers and printers
- Infrequent lifting to 15 pounds
- Infrequent stooping
- Periodic travel
Segregation of Duties
Employees are accountable for performing their job responsibilities per Rainmakers’ core values, as well as policies and procedures, including but not limited to: segregation of duties, HIPAA, security and privacy, CMS requirements, the Rainmakers Compliance Program and any other applicable laws, rules and regulations.
Statement of Other Duties
This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functions. Employees may be requested to perform job related tasks other than those specifically listed in this description and may be required to perform any task requested by the supervisor or management.
Equal Employment Opportunity
Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities as well as Sexual Orientation or Gender Identity.
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