Support Specialist I

Posted 7 Days Ago
Be an Early Applicant
San Diego, CA
59K-97K Annually
3-5 Years Experience
Healthtech • Pharmaceutical
The Role
The Support Specialist II provides operational support for the Medicare Part D program, working across teams and with clients to ensure accurate claims data and reporting. Duties include analyzing reports, performing root cause analysis to improve processes, and maintaining relationships with clients to ensure timely execution of project activities.
Summary Generated by Built In

Exemption Status:United States of America (Non-Exempt)

$50,668 - $66,497 - $82,326

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Summary: The GPS Support Specialist works internally across functional teams and with external clients. The position interfaces with designated client employees for their Part D support of the Medicare Part D program and related processes. This role provides operational support for programs and processes which includes True Up and its related activities, FIR transaction rejection resolution, Medicare Part D Plan Finder, CMS Required Reporting, Retiree Drug Subsidy services as well as other specified activities supporting Government Program and Services. This position requires technically complex analysis and a high degree of accuracy, carrying with it significant consequence for the organization and MedImpact’s clients should errors occur.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

  • Performs analytical report analysis and validation; partners with IT and department members within GPS.
  • Maintains current understanding of customers, Medicare Part D coverage and benefit plans in order to accurately analyze reports. Performs calculations, complete quality control and testing, and ensure appropriate updates and adjustments of data prior to submission to customers.
  • Establishes positive working relationships with internal and external clients by providing sustainable, measurable, accurate, reliable and timely execution of Part D project activities and responsibilities. Supports the corporate strategy by delivering solution-oriented problem solving.
  • Utilizes multiple company databases to obtain, record, and analyze Part D claim data and information. Completes project activities within the prescribed time frame to ensure timely and accurate delivery of Part D services. Works proactively under strict deadlines to manage client expectations on issue resolution and provides customer support to address action items and problems.
  • Participates in interdepartmental meetings and customer conference calls regarding CMS Medicare Part D requirements, and MedImpact Medicare Part D processes, system capabilities and report file-standards/formatting on topics such as (but not limited to) True Up, RetroLICS Attestations, FIR Transaction rejection resolution, Medicare Part D Plan Finder, Centers for Medicare and Medicaid Services (CMS) Required Reporting, and Retiree Drug Subsidy services. 

Supervisory Responsibilities 

This job has no supervisory responsibilities.

Client Responsibilities

This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written).  One must be able to; Respond promptly to client needs. Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients; Manage difficult or emotional client situations.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

Associate’s degree in a related field (or equivalent combination of education and experience) along with 1 - 2+ years’ related experience working with Medicare Programs, PBM, Managed Healthcare setting, or a regulatory agency.

Computer Skills

  • Good working knowledge of MS Excel and MS Access 
  • Basic level of expertise in MS Word and MS Outlook
  • Experience with system analysis, systems quality, or data analysis experience (desired)

Other Skills and Abilities

  • Basic understanding of claim processing concepts
  • Ability to prioritize urgent issues effectively
  • Ability to calculate figures and amounts such as discounts, interest proportions and percentages
  • Knowledge of healthcare operating systems in PBM industry preferred 
  • Detail oriented with a high degree of accuracy & follow-through on work deliverables
  • Self-starter with the ability to work independently
  • Proven analytical and decision making skills
  • Ability to effectively balance a high volume of work 
  • Ability to work in a team environment and develop good working relationships 
  • Able to resolve problems and possess judgment and decision making skills

Reasoning Ability

Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.

Ability to define problems, collect data, establish facts, and draw valid conclusions.

Mathematical Skills

Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages. Ability to apply concepts of basic algebra.

Language Skills

Ability to read and interpret documents such as procedure manuals, operating and maintenance instructions. Above average written communications skills exhibited by the ability to write routine reports and correspondence. 

Competencies

To perform the job successfully, an individual should demonstrate the following competencies:

  • Problem Solving - Analyzes problems logically to identify root causes, seeks input from a wide range of sources, asks insightful questions and formulates effective solutions.
  • Productivity - Achieves high-quality, concrete results, completing tasks quickly and responding to problems as they arise in order to ensure that deadlines and production goals are met.
  • Technological Competence - Effectively uses technologies required for the job, has the necessary skills to operate technological tools, software packages and/or machines required for the job, integrates new technology into the workplace as appropriate to improve performance, and selects the most appropriate technology for the task.

Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit and talk or hear. The employee is frequently required to use hands to finger, handle, or feel and reach with hands and arms. The employee is occasionally required to stand; walk and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The noise level in the work environment is usually moderate.

Work Location

This position works on-site at the San Diego Headquarters (or other company location) for purposes of providing adequate support to internal clients; being available for face-to-face interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as for facilitation of quick and effective decisions through collaboration with stakeholders. Periodic scheduled remote work may be permitted as allowed under the department’s policy and with management approval. 

Working Hours

This is a non-exempt position requiring one to be able to work overtime from time to time in order to get the job done. Therefore one must have the ability to work nights, weekends or on holidays as required. This may be changed at any time to meet the needs of the business. The typical working hours for this position are Monday through Friday from 8:00am to 5:00pm.

Travel - This position requires no travel; however, attendance may be required at various local conferences and meetings.

The Perks:

  • Medical / Dental / Vision / Wellness Programs
  • Paid Time Off / Company Paid Holidays
  • Incentive Compensation
  • 401K with Company match
  • Life and Disability Insurance
  • Tuition Reimbursement
  • Employee Referral Bonus

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego,
California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/VeteransOSHA/ADA:

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer:

The above
statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.

The Company
San Diego, CA
1,400 Employees
On-site Workplace
Year Founded: 1989

What We Do

MedImpact, an independent, trend-focused pharmacy benefit manager (PBM), is the nation’s largest privately held PBM, serving health plans, self-funded employers and government entities. Our business model is unique. We focus on effectively managing client pharmacy benefits to promote Lower Cost and Better Care through One Source. Our model aligns us with our clients. We help promote prescribing of lower-net-cost, medically appropriate drugs with fulfillment at the most appropriate participating pharmacy providing competitive pricing, good value and high-quality service.

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