What are the responsibilities and job description for the Sr Program Specialist, Medicare position at Lensa?
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Job Description
Job Summary
Responsible for the management of the benefits, operations, communication, reporting, and data exchange of the Medicare/MMP product in support of strategic and corporate business objectives. Manage for all Medicare lines of business the annual Medicare and Medicare-Medicaid Plan Applications and Plan Benefit Package design, as well as provide centralized year-round support of Medicare Growth Marketing, for the development and core editing of materials as required by Mandated Materials team, to include the Annual Notice of Change, Medicare Summary of Benefits, evidence of Coverage and Mid-Year Supplemental Benefit Notices for print and online distribution via the Data Automation Tools, ensuring compliance with CMS and State guidelines. Support Medicare and MMP line of business for upcoming contract year business readiness. This position also needs to assist in the development, implementation, and maintenance of annual timelines/work plans to ensure timely and successful project completion including adhoc projects and submissions as assigned by the Manager of Mandated Materials or designee.
Knowledge/Skills/Abilities
Required Education
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $77,969 - $128,519 / ANNUAL
Job Description
Job Summary
Responsible for the management of the benefits, operations, communication, reporting, and data exchange of the Medicare/MMP product in support of strategic and corporate business objectives. Manage for all Medicare lines of business the annual Medicare and Medicare-Medicaid Plan Applications and Plan Benefit Package design, as well as provide centralized year-round support of Medicare Growth Marketing, for the development and core editing of materials as required by Mandated Materials team, to include the Annual Notice of Change, Medicare Summary of Benefits, evidence of Coverage and Mid-Year Supplemental Benefit Notices for print and online distribution via the Data Automation Tools, ensuring compliance with CMS and State guidelines. Support Medicare and MMP line of business for upcoming contract year business readiness. This position also needs to assist in the development, implementation, and maintenance of annual timelines/work plans to ensure timely and successful project completion including adhoc projects and submissions as assigned by the Manager of Mandated Materials or designee.
Knowledge/Skills/Abilities
- Experience in developing materials in data automation tools, SQL queries (optional)
- Initiate projects by documenting the project scope including goals, objectives, timelines, milestones, deliverables and obtaining approval of the project owner.
- Plan projects by creating process improvement workflows, project presentations, work plans, establishing due dates, and assigning task responsibilities.
- Guides project efforts by leading work teams and utilizing effective project management tools to achieve desired project results.
- Monitor and control projects by measuring progress according to plan and making course corrections as needed to keep the project on track.
- Provide interim reports and keeping the project sponsor and stakeholders informed of progress and risks.
- Serves in an internal consultant capacity and possesses ability to rapidly learn, assess, and implement projects.
- Develop and distribute internal communications.
- Spearhead submission of Medicare and MMP materials (as assigned), annual Medicare Bid and PBP, ANOC/EOC, and Summary of Benefits working closely with a variety of internal and external partners. Responsible for staying up to date with the latest communications and guidance provided by CMS as it relates to applicable projects.
- Coordinate cross-departmental informational updates – focusing on teamwork, information flow and support data to promote cross-training and unified team direction.
- Collaborates with implementation team for Annual implementation and roll out of business expansion for Medicare/MMP lines of business.
- Ensures materials developed are 508 compliant for web posting and receive Certificate of Accuracy (COA) for translations.
Required Education
- Bachelor’s degree or equivalent years of education and experience
- 1-2 years of experience in Information Technology, database Content Management Systems environments.
- 5 years in healthcare process design and development, business analysis, compliance, project management or related experience.
- 2 years’ experience in Medicare and/or healthcare
- 1 year experience in project management.
- 1-2 years in content management systems
- 3-5 years in project coordination/management, business analysis, compliance.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $77,969 - $128,519 / ANNUAL
- Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
Salary : $77,969 - $128,519
