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Indiana University Health

Consultant-Part D Compliance

IU Health Plans
Date Posted
12 April, 2021
Schedule & Shift
Full Time
Day
Requisition Number
305996
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Consultant-Part D Compliance

Job Description

Overview

Reviews routine monitoring reports for timeliness, correctness, and analytics and responds with feedback. Conducts compliance audits for coverage determinations, appeals, and other activities related to them. Collaborates with business owners and vendors in managing Corrective Action Plans (CAPs) for Part D issues. Oversees the data validation and reporting of the Prescription Drug Events (PDE) and Part D Medication Therapy Management Programs (MTMP).Provides guidance on HPMS Part D regulatory changes and reporting. Maintains collaborative relationships with Part D delegated entities.


 Bachelors degree preferred.
• Part D compliance oversight related to regulatory compliance required.
• Certified Pharmacy Technician (CPhT) preferred.
• Knowledge of CDAG issues preferred.
• Familiarity with CMS Audit protocols preferred.
• 5-7 years of experience required.
• Part D auditing experience, monitoring oversight and reviewing CAPs preferred.

 

We are an equal opportunity employer and value diversity and inclusion at IU Health. IU Health does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status or any other characteristic protected by federal, state or local law. We will ensure that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodation.

Qualifications for the Consultant-Part D Compliance Role

Overview

Reviews routine monitoring reports for timeliness, correctness, and analytics and responds with feedback. Conducts compliance audits for coverage determinations, appeals, and other activities related to them. Collaborates with business owners and vendors in managing Corrective Action Plans (CAPs) for Part D issues. Oversees the data validation and reporting of the Prescription Drug Events (PDE) and Part D Medication Therapy Management Programs (MTMP).Provides guidance on HPMS Part D regulatory changes and reporting. Maintains collaborative relationships with Part D delegated entities.


  • qualifications__list
     Bachelors degree preferred.
  •  Part D compliance oversight related to regulatory compliance required.
  •  Certified Pharmacy Technician (CPhT) preferred.
  •  Knowledge of CDAG issues preferred.
  •  Familiarity with CMS Audit protocols preferred.
  • 5-7 years of experience required.
  •  Part D auditing experience, monitoring oversight and reviewing CAPs preferred.

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Indiana University Health is Indiana’s most comprehensive health system, with 16 hospitals and more than 34,000 team members serving Hoosiers across the state. Our partnership with the Indiana University School of Medicine gives our team members access to the very latest science and the very best training, advancing care for all. We’re looking for team members who share the things that matter most to us. People who are inspired by challenging and meaningful work for the good of every patient. People who are compassionate and serve with a purpose. People who aspire to excellence every day. People who are always ready to apply themselves.

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Consultant-Part D Compliance

Indianapolis, IN, United States
IU Health Plans

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