Director, Medicare and Data Compliance

Dice is the leading career destination for tech experts at every stage of their careers. Our client, ConsultNet, LLC, is seeking the following. Apply via Dice today! The Director of Medicare and Compliance Data, will be responsible for analyzing and interpreting pharmacy data related to Medicare programs, specifically focusing on CMS Direct Subsidy, PDE, and MMR. The role involves working with large datasets, ensuring compliance with CMS regulations, and providing insights to improve healthcare outcomes and financial performance. They will work closely with other team members to collaborate and support team processes. They will be responsible for leading our compliance reporting efforts and partner with key business stakeholders. KEY RESPONSIBILITIES: • Analyze Medicare data, including PDE submissions, MMR reports, and CMS Direct Subsidy allocations • Work with Finance and Account Management to project yearly Medicare changes • Ensure data accuracy and compliance with CMS guidelines and reporting requirements • Own and maintain reporting processes needed to support organization compliance requirements • Maintain and manage large datasets related to Medicare Part D and other relevant programs • Monitor performance through tracking trends and identifying discrepancies in subsidy allocations and prescription drug events • Work with cross-functional teams, including finance, IT, Account Management, and Compliance to optimize Medicare data usage • Lead process improvement through developing strategies to enhance data collection, reporting, and analysis efficiency • Design, build, and maintain business intelligence reporting in collaboration with team leadership • Continually focus on growing technical skills related to reporting tools and coding languages • Partner with leadership and other key business contacts to ensure Medicare data and reporting knowledge is developed and maintained • Support ad-hoc and reoccurring work as needed QUALIFICATIONS: • Highly creative and possess the ability to manage several projects concurrently • Ability to prioritize effectively and to work efficiently • Ability to work both autonomously and together as a team • Highly organized and deadline driven • Professional communication skills, both oral and written to all levels of an organization KNOWLEDGE, EXPERIENCE, AND EDUCATION: • Bachelor's Degree in related field, or equivalent experience • 7+ years' experience in pharmacy benefit management, health insurance, or related industry • Experience with Medicare Part D data, including PDE and MMR reporting • Strong understanding of CMS regulations and healthcare analytics • Intermediate to expert in SQL, SAS, R, Python, or other database languages • Intermediate to expert in Power BI, Tableau, Qlik, or similar tool, preferred COMPENTENCIES: Collaborates Building partnerships and working collaboratively with others to meet shared objectives. Manages Conflict Handling conflict situations effectively, with a minimum of noise. Courage Stepping up to address difficult issues, saying what needs to be said. Decision Quality Making good and timely decisions that keep the organization moving forward. Values Differences Recognizing the value that different perspectives and cultures bring to an organization. Directs Work Providing direction, delegating, and removing obstacles to get work done. Welcome to ConsultNet and the family of companies, Tekne, SaltClick, TechBridge, and OmniMedia. As a premier national provider of technology talent and solutions, our expertise spans across project services, contract-to-hire, direct placement, and managed services both onshore and nearshore. Celebrating more than 25 years of partnership with a diverse client base, we've crafted rewarding opportunities for our consultants, fostering high-performing teams that deliver impactful results. Over the last few years thousands of consultants have found their calling with us in roles that have made a meaningful impact on their lives, enhanced their career, challenged them, and propelled them towards achieving their personal and professional goals. At the ConsultNet family of companies, we believe effective communication is crucial in aligning the right job with your unique skills and professional aspirations. To us, it's all about the personal approach we take and the values we uphold. Our comprehensive service offerings cover a wide range of technology positions across key markets nationwide. Client more at . We champion equality and inclusivity, proudly supporting an Equal Opportunity Employer policy. We welcome applicants regardless of Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other status protected by law.