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DescriptionThe Enrollment Analyst will support Employer Groups or State Pharmaceutical Assistance Programs (SPAPs) who wish to batch enroll their Medicare D eligible members into a Medicare Part D plan for which our company offers enrollment services.
The Enrollment Analyst will be expected to maintain a client list with some management supervision. Clients assigned to the Enrollment Analyst will be small to medium in size, and of simple to moderate complexity in terms of client requirements. The Enrollment Analyst may assist in the implementation of new employer group or SPAP business sold. The Enrollment Analyst will work closely with their Clients and internal partners (primarily account management) to ensure the timely, accurate, and compliant enrollment, maintenance, and disenrollment of the client's beneficiaries.
The Enrollment Analyst is expected to have some basic understanding of Electronic Data Interchange formats and file transfer protocols, as most employer group or SPAP enrollments are done via electronically submitted batch files.
The Enrollment Analyst will be expected to load employer group enrollment files within mandated CMS turnaround times, and to ensure successful and compliant enrollment of all of the employer group's beneficiaries.
The Enrollment Analyst will draft, review and provide input into operational work instructions, policies and procedures as necessary.
The Enrollment Analyst may be asked to complete assigned tasks for projects, taking direction from a designated project lead, on an as needed basis.
As Medicare Part D Enrollment is highly regulated by the Centers for Medicare and Medicaid Services (CMS), there is a great deal of emphasis placed upon compliance. Many of the deliverables associated with this position are time sensitive in nature, due to CMS mandated delivery dates and/or internal turn around times that must be met. The Enrollment Analyst must continually review CMS guidance to ensure their defined processes and work instructions remain compliant.
The Enrollment Analyst must keep management informed as to task progress. The Enrollment Analyst must escalate any potential issues or missed deadlines that could result in noncompliance. Due to the seasonal nature of Medicare Part D enrollment, the Enrollment Analyst may be asked to perform other duties within enrollment operations as needed.
Verifiable High School Diploma or GED
This position analyzes client benefit requests, determines best operational approach and performs coding. Validates coding accuracy utilizing various tools to ensure no financial impact or client/participant dissatisfaction. Researches client benefit requests/issues and recommends alternative solutions to internal partners in meeting client needs. Manages data integrity of eligibility interfaces and Health Welfare premium payment and reconciliation processes. Works closely with the Supervisor of the Benefits Center and Benefits Analyst - PeopleSoft Benefits Admininstration to ensure best quality benefits services to employees. Interfaces with internal systems team and external vendors regarding set-up requirements, testing, implementation, and maintenance of ongoing and new eligibility files. Assists with planning, testing, implementation, and support of Annual Enrollment process and other benefits plan changes, policies, or procedures.
Strong problem solving, analytical, organizational, interpersonal, communication, and presentation skills required.
Demonstrated ability to analyze data and determine conclusions and skilled in identifying and solving issues.
Considerable experience with PeopleSoft desired.
Benefits background preferred.
Ability to determine internal and external vendor requirements for new and ongoing eligibility files.
Will interface with HRIS and HRIT teams regarding set-up, testing, implementation, and maintenance of eligibility files, premium payment requirements, and system upgrades.
Design, develop, and maintain required and/or ad hoc reports relating to claims costs and employee/employer contributions.
Assist with implementation and administration of voluntary benefit programs, including generation of census files and interfacing with payroll to ensure accuracy of payroll deductions.
Responsible for the daily administration of Company 401(k), pension, deferred compensation, and any other retirement plans for which the department has oversight.
Administers the Employee Stock Purchase Plan, including but not limited to, stock purchases, trust reconciliation, IVR file processing, eligibility files, and communications.
Primary liaison with plan vendors on a daily basis with regards to plan administration, compliance and reporting requirements, communications, and various projects.
Ensures timeliness and accuracy of vendor file interfaces and payroll wires.
Resolve daily participant issues and questions regarding retirement and stock purchase plans.
Minimum 3 to 5 years related experience and/or training.
Solid Excel skills/expertise required.
Considerable experience with PeopleSoft desired.
PeopleSoft Benefits Administration module experience ideal. Benefits background required.
High School Diploma or GED required.
Bachelors degree in related field or equivalent work experience preferred.