GEHA (Government Employees Health Association, Inc., pronounced G.E.H.A.) is a nonprofit member association that provides medical and dental benefits to more than two million federal employees and retirees, military retirees and their families. We celebrate diversity and are committed to creating an inclusive environment for all employees.

GEHA has one mission: To empower federal workers to be healthy and well.

Offering one of the largest medical and dental benefit provider networks available to federal employees in the United States, GEHA empowers health and wellness by meeting its members where they are, when they need care. We serve our members with products they value and a personalized customer experience, sustained by a nimble and efficient organization.

The Medicare Part D Performance Management Specialist will report to the Director of Pharmacy and will be responsible for monitoring contractual, operational, reporting, and regulatory requirements for Medicare Part D / EGWP lines of business.

SKILLS

Responsibilities:

Serves as a subject matter expert to Centers for Medicare & Medicaid Services (CMS) Part D / EGWP regulatory requirements.
Able to navigate and research CMS policies and memorandums specific to Part D / EGWP and provide guidance to the plan and vendor partners.
Oversees and maintains the fully insured Part D / EGWP administrator contractual and regulatory functions.
Responsible for analyzing data specific to Part D / EGWP on all lines of business.
Monitor key performance indicators in clinical, operational, and vendor management areas to proactively inform leadership and departmental business owners of risks and issues from the administrator.
Track critical issues and work cross-functionally with internal and external business owners focusing on the remediation activities while maintaining strong lines of communication.
Develop and monitor corrective action plans for areas that are not meeting contractual and regulatory requirements.
Work in conjunction with the Vice President and Director of Pharmacy to align Medicare Part D / EGWP lines of business to organizational goals and initiatives.
Performs other related duties and projects as assigned.

Education & Experience:

3 or more years of managed care experience, specifically in relation to pharmacy benefits.
2 or more years of experience in Medicare Part D / EGWP.
Bachelor’s Degree or equivalent experience
Knowledge of Medicare Part D STARs measures.
Experience with computer-based data processing including Microsoft Office products, and database application.
Information analysis for problem-solving and solution development.
Strong verbal and written communication skills.
Experience with prioritizing the demands of multiple tasks while meeting essential deadlines.
Proven self-starter with the ability to lead multiple projects in a fast-paced, changing environment.

#LI-Remote

Work-at-home requirements

Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office.
A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required.
Latency (ping) response time lower than 80 ms
Hotspots, satellite and wireless internet service is NOT allowed for this role.
A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

How we value you

Competitive pay/salary ranges
Incentive plan
Health/Vision/Dental benefits effective day one
401(k) retirement plan: company match – dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution
Robust employee well-being program
Paid Time Off
Personal Community Enrichment Time
Company-provided Basic Life and AD&D
Company-provided Short-Term & Long-Term Disability
Tuition Assistance Program

Please note that the salary information is a general guideline only. GEHA considers factors such as (but not limited to) scope and responsibilities of the position, candidate’s work experience, education/training, key skills, internal peer equity, as well as, market and business considerations when extending an offer.

The annual base salary range for this position is $73,372 - $103,428 USD.

GEHA is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual orientation, as well as all other characteristics and qualities protected by federal, state, or local law. GEHA will not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their compensation or the compensation of another employee or applicant. We are committed to creating an inclusive environment for all employees. Our diversity drives innovation deepens connections and strengthens our organization.

GEHA is headquartered in Lee's Summit, Missouri, in the Kansas City area. We recognize the importance of balance and flexibility and offer hybrid and work-from-home options for many of our roles.