Federal Government Relations Specialist - Part D
Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs. UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.
ABOUT UCAREAt UCare, we deliver high-quality health coverage and services to help members of all ages maintain and improve their health. It's a big job that takes innovative ideas, strategic partnerships, and a commitment to doing the right thing. Above all, it takes a compassionate team that is dedicated to making a real difference in the lives of our members and our communities. WORKING AT UCAREWorking at UCare is more than just a career; it's a mission. A mission that defines us as professionals, unites us as an organization, and shapes how we interact with our members and each other. Our values of integrity, community, quality, flexibility, and respect permeate every aspect of our organization - from who we are and how we act, to what we do and how we do it. We owe our continued success to our employees who proudly embody our mission and values in everything they do. FEDERAL GOVERNMENT RELATIONS SPECIALIST - PART D Position DescriptionProvide contract oversight activities for Centers for Medicare & Medicaid Services (CMS) contracts. Coordinate regulatory and contract communications with CMS and coordinate and manage internal communication of CMS Medicare Advantage Part D and Special Needs Plans (SNPs) guidance. With oversight and direction from Federal Government Relations Manager, manage federal requirements of Part D activities. Project manage Medicare Advantage new and expansion applications, non-financial audits and other activities. Research and analyze guidance primarily related to Medicare Part D. Specific duties and responsibilities include: Primary liaison with CMS for Part D communications, policy and operational issues. Work with CMS and internal departments on analysis and interpretation of CMS regulatory requirements. Monitor and/or perform Part D activities including reporting formulary submissions, coordinating with multiple departments related to routine and ad hoc reporting, and responding to CMS requests for information. Receive, analyze, and distribute Part D regulatory, sub-regulatory and policy information, including federal laws, regulations and guidance from CMS, CMS' Health Plan Management System (HPMS), the Federal Register and trade associations. Proactively identify impact on Medicare Advantage products. Educate departments about Part D requirements and contractual obligations. Monitor department work for implementation of new/changed requirements. As assigned, coordinate projects/operational implementation. Collaborate with Corporate Compliance, provide support identifying and addressing compliance issues.Project manage and/or support work on new and expansion Medicare Advantage applications, including internal planning and gathering, reviewing and verifying application information and/or necessary regulatory requirements.Project manage certain CMS non-financial audits (e.g., program audit, data validation audit, timeliness monitoring), including universe and sample submissions to CMS and review of policies and procedures. Work with Federal Government Relations Manager to identify risks and vulnerabilities and, as requested, support information sharing with the Vice President Government Relations, Vice President Corporate Compliance and Legal Counsel. Post audit, coordinate documentation and other follow-up activities. With Corporate Compliance, work with internal departments to develop, submit, receive approval of, and monitor corrective action plans for identified issues until closure by CMS. Maintain electronic documentation of monitoring activities and corrective actions. Support communication of compliance monitoring within Government Relations, Corporate Compliance and senior leadership. Manage access to CMS systems: (1) Health Plan Management System (HPMS) - issue HPMS applications to staff and contractors; verify for completeness and submit to CMS. Grant access for staff to certain role-based modules. At least semiannually, verify and update required contacts and organizational information in HPMS; (2) Enterprise Identity Management (EIDM) - serve as primary External Point-of-Contact for UCare contracts. Review all received EIDM requests, verify for appropriateness and coordinate with department managers to update access; and (3) Acumen - verify and make recommendations to the Vice President of Corporate Compliance regarding staff access to modules. Serve as subject matter expert and super user for guidance distributed by Federal Team using U360, UCare's web-based tool for managing regulatory guidance, compliance incidents and drafting/storing policies and procedures. Use U360 workflows (daily) and work collaboratively within and outside of GR on needed process improvement/refinements. Issue guidance and monitor compliance with requirements. Run reports and manage work load according to team timelines. Create assessments. Participate in GR U360 process improvement efforts as needed. Serve as back up for Federal Government Relations Specialist - Part C.Other projects and duties as assigned. EducationBachelor's degree is required.Required ExperienceThree years in health care compliance, health insurance and/or managed care. Medicare Part C or D program administration experience Preferred ExperienceProject management experience. Knowledge and/or experience with dual integrated SNPs (Part D related operational functions).THE UCARE DIFFERENCEUCare is proud to be a recognized Star Tribune Top Workplace for the 9th consecutive year. As a part of our collaborative team, you'll experience the rewards that come with helping others and seeing the positive results of your hard work. We value and respect each individual's ideas and contributions, and give you the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, a myriad of volunteer activities, and a number of other rewards. If you're looking for a welcoming environment that celebrates what you have to offer, helps you build on your strengths, and gives you the opportunity to truly make a difference, we invite you to apply. As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.