Medicare Part D Letters Analyst

Summary

Join Abarca, a revolutionary healthcare company redefining pharmacy benefits, and become a Medicare Part D Letter Analyst. You will investigate and resolve complex issues using strong analytical and communication skills, monitoring letter processes for Medicare Part D business. This role involves analyzing data, identifying process improvements, and collaborating with various teams. A bachelor's degree or equivalent experience and 3+ years of relevant experience are required. The position offers a flexible hybrid work model (Puerto Rico location only) and opportunities to contribute to a dynamic and growing company.

Requirements

• Bachelor’s degree in a related field
• 3+ years of combined or relevant work-related experience
• Experience with Medicare Part D processes within a pharmacy benefit manager or health plan
• Ability to analyze data, reports, and findings to discern patterns and discrepancies
• Problem solving and analytical skills that are applicable to role processes and procedures
• Ability to thrive in a high-growth, fast-paced, complex, shifting, and uncertain business environment
• Highly organized and self-motivated to run and complete important investigations simultaneously
• Excellent oral and written communication skills
• Must be able to access and navigate each department at the organization’s facilities
• Sedentary work that primarily involves sitting/standing

Responsibilities

• Monitor Part D letters and dashboards; identify and initiate error resolution as necessary
• Analyze pharmacy claims, formulary, provider data, and pricing changes and determine how those affect downstream letters
• Track, trend, and monitor issues as they arise
• Understand and reference guidance when analyzing and resolving issues
• Identify and proactively suggest process improvements
• Document and explain observations to technical and non-technical audiences
• Provide guidance and solid understanding of Medicare Part D processes the impact letters
• Assist in new client implementations and existing client re-implementations to ensure accurate letter logic and content
• Locate, read, understand, and apply CMS guidance to processes as necessary
• Understand and execute the quality assurance checks on Medicare Part D processes and communications
• Review inbound and outbound data files, utilize reports to ensure Medicare Part D process accuracy in various business functions
• Stay up to date on CMS guidance related to Medicare Part D products
• Provide client support and/or compliance/audit activities and collaborate in special projects and activities

Preferred Qualifications

Experience with pharmacy paid claim calculations and accumulators is strongly preferred

Benefits

Flexible hybrid work model which will require certain on-site work days (Puerto Rico Location Only)