Responsibilities
- Manage the Government Programs Operations team shared Outlook mailbox, including but not limited to timely, accurate and complete responses, and ensuring timeframes for deliverables.
- Lead and execute pharmacy outreach initiatives related to CMS disputes, ensuring compliance with regulatory requirements and internal Government Operations procedures while applying judgment in communication strategy and issue resolution
- Serve as a key contributor in the validation of system enhancements, including evaluating output data, identifying discrepancies, and providing recommendations to improve system performance and data integrity.
- Design, maintain, and continuously improve structured documentation frameworks, including job aids, policies and procedures (P&Ps), standard operating procedures (SOPs), and training materials to support operational consistency and scalability.
- Develop and optimize internal workflows and job aids, driving process standardization and identifying efficiency opportunities across Government Programs Operations.
- Oversee daily PDE reconciliation activities, analyzing trends, identifying variances, and proactively addressing discrepancies to ensure data accuracy and compliance.
- Manage and resolve escalations arising from claims monitoring activities by applying critical thinking, root cause analysis, and cross-functional collaboration.
- Support strategic Government Programs Operations initiatives, contributing insights, process improvements, and subject matter expertise as assigned.
- Plan, coordinate, and facilitate cross-functional meetings to drive alignment, resolve issues, and advance operational objectives.
- Collaborate closely with Government Programs Operations team members and business partners to address operational needs, improve processes, and support broader organizational goals.
Requirements
- 3+ years of experience in an equivalent role
- High school diploma required
- Organizational skills and a very keen eye for detail and accuracy.
- A positive and upbeat attitude, and excellent interpersonal communication skills.
- A commitment to delivering a high level of customer service, both internally and externally.
- Flexibility to respond to a range of different work situations.
- An ability to work under pressure and juggle multiple priorities at any given time.
- An ability to work well independently and be an effective collaborator within and across teams.
Nice to Have
- Experience with Medicare Part D and/or Pharmacy Technician experience preferred
- Experience working in high-growth, startup environments - an advantage.
