P10 Contract Project Analyst

Apply by eMail:15330685.185@jobfrenzy1.com

Description:
Humana Inc., headquartered in Louisville, Kentucky, is one of the nation's largest publicly traded health benefits companies. Humana offers a diversified portfolio of health insurance products and related services - through traditional and consumer-choice plans - to employer groups, government-sponsored plans, and individuals.

Today, Humana is a leader in consumer engagement. Throughout its diversified customer portfolio, the company provides guidance that can both help lower costs and lead to a better health plan experience.

Role: P10 Project Analyst
Assignment: HPS Operations - Transaction Processing
Location: Louisville, KY - Bishop Lane

Assignment Capsule
The Humana Pharmacy Operations - Transaction Processing Team has a unit dedicated to the oversight of a newly-awarded CMS contract entitled P10. Humana will now provide Medicare Part D drug coverage for retroactive periods for certain eligible beneficiaries as well as beneficiaries with Part D low income subsidy (LIS) who are not yet enrolled in a Part D plan. This position will monitor all required CMS reporting related to claims, facilitate monitoring of eligibility reporting issues and monitor
day-to-day compliance issues including DMRs. This position will also serve as a primary resource for testing any system changes required in Argus or Humana related to the P10 contract. This will involve coordination with HPS Quality Assurance Team and Argus to create, submit and review testing macros. It will also include participation on User Acceptance Testing (UAT) conference calls. The Pharmacy Operations P10 Project Analyst must become familiar with all CMS guidance related to P10 contract processing requirements. The Analyst will be responsible for ensuring accuracy of the newly implemented P10 processes and for working with IT and other Humana departments to support these processes. This position provides analysis and information regarding applicable CMS requirements and will assist the manager in assuring that Humana's processes are in compliance with CMS requirements.

Key Competencies
Builds Trust: You are emotionally intelligent; manages self and relationships effectively, through self-awareness, self-management, awareness of others and skill in dealing with others.
Drives for Excellence: You demonstrate the ability to achieve results and win through continuous upgrading of your own and others work performance. You take the initiative to help others develop and enhance their capability to contribute to Humana. You seek out learning from your own experience, from other people and from other resources, and contribute to others learning.
Problem Solving: You are a problem solver with the ability to encourage others in collaborative problem solving. You look beyond the obvious to see root cause issues and creative solutions.
Implementation/Execution: You are good at organizing and managing multiple priorities and/or projects by using appropriate methodologies and tools. You anticipate and resolve barriers and constraints.

Role Essentials
Success in this role requires:

Knowledge of pharmacy claims processing systems and processes, enrollment eligibility systems and processes, as well as a sound understanding of financial processes.
Excellent organizational and time management skills with attention to detail.
Prior problem solving experience, including root cause analysis and resolution.
Medicare Part D experience, especially Pharmacy related.
Comprehensive knowledge of Microsoft Access and Excel.
Demonstrated expertise in data preparation and analysis.
Ability to work independently and within a team setting.

Role Desirables
Experience with the following, while not required to be considered for this position, would be valuable:

Experience with Pharmacy reporting or the Pharmaceutical industry would be a plus.

Reporting Relationships
Reports to Process Manager

Requirements:
See Above

Education: Not Specified

Experience: At Least 3 Years

Travel: None

Apply by eMail:15330685.185@jobfrenzy1.com

Job Created: Fri Oct 16 2009 04:27:17 AM
Last Modified: Fri Oct 16 2009 04:27:17 AM