Softrams is a Maryland- and Virginia-based small business consultion, and solutions provider specializing in emerging technologies for UX/UI, Mobile Apps, DevOps, Big Data Analytics, Data Science, and Cyber Security. We offer innovative technology implementations and build customer-centric services that are simple, intuitive, scalable, efficient and most importantly usable.
Softrams is seeking a strong Sr. Health Policy Analyst with expertise in Medicare Advantage and/or Part D data and policy. This role is part of a collaborative and agile team that builds modern, standards-based responsive solutions for CMS mission-critical health programs that support Medicare beneficiaries.
In this key role, you will use your skills to provide Medicare data-driven policy expertise supporting an effort to develop information systems that serve a critical role in the daily operations and high-profile initiatives of the Medicare Advantage (MA) and Prescription Drug (Part D) programs. You will provide data management, statistical analyses, project management, and other research activities in health policy, and use advanced research skills to perform a variety of research and systems development activities.
The ideal candidate has strong knowledge of publicly funded health insurance programs, excellent communication skills including the ability to communicate verbally and in writing to diverse audiences including senior program management, extensive experience with Medicare and other health insurance administrative claims data, especially Part C and D enrollment and claims data, experience working with the Centers for Medicare & Medicaid Services (CMS), willingness to contribute to the work of multi-disciplinary teams in a fast-paced environment, and can provide Medicare expertise for a system development team. As a client-facing expert, you will use your knowledge of MA and/or Part D to drive the data analysis and system requirements elicitation process with CMS staff. Additional responsibilities include producing summary report(s) that integrate policy and data analyses, identify current gaps in in the application, present refined prototypes and reports detailing incorporation of policy within the current program, and give options to further address policy issue(s). Reports and briefings should also include relevant parameters and recommendations for further action.
Roles and Responsibilities:
- Uses expertise in MA and/or Part D to drive the business requirements and demonstrates this expertise in client-facing requirements development sessions.
- Producing summary report(s) that integrate policy and data analyses, identify current gaps in in the application, present refined prototypes and reports detailing incorporation of policy within the current program, and give options to further address policy issue(s).
- Develops and executes analytic plans, and interprets complex analyses.
- Combines data from multiple sources to derive conclusions, measures and recommendations.
- Communicates analysis of CMS policy and regulations to the team. Keeps up-to-date with CMS guidance changes. Anticipate effects on the system of regulatory or policy changes. Understands and interprets guidance as it applies to the development effort, and makes recommendations to incorporate necessary changes into the business requirements.
- Works with product managers, product owners, system architect, business analysts, and full-stack developers to resolve client issues.
- Maintains familiarity with the various MA and/or Part D plan designs, including operations, annual requirements, benefit setups, pharmacy networks, claims adjudication and/or formulary.
- Relies on experience, judgment and systems knowledge to accomplish goals.
- Leads communication of policy with various internal and external stakeholders throughout the team. Demonstrates exceptional presentation skills; prepares presentations and presents information to client and team.
- Masters’ Degree and expertise in statutory, regulatory, and administrative guidance that governs business requirements for the MA and/or Part D programs.
- Knowledge of Medicare Part C and D regulations, operations and provide enrollment
- Excellent oral and written communication skills and must be detail oriented.
- Must be able to effectively and professionally communicate to management, peers and customers as well as demonstrate sound judgment/reasoning skills.
- Expertise with Microsoft Office applications (Word, Excel, Power Point, SharePoint, etc.).
- Experience with using policy expertise to develop system requirements.
- Must be able to successfully complete Public Trust background investigation.
- Six (6) or more years of experience working with any of the following: CMS, MA, Prescription Drug Plan (PDP), cost-based, Program for All-Inclusive Care (PACE), and demonstration organizations and affiliated industry groups, private health and drug plans, pharmaceutical manufacturers, States, consultants and third-party vendors, related federal agencies, and CMS contractors.
- Broad knowledge of Healthcare, Medicare & Medicaid systems and data is a plus.
- Experience in a CMS system development or policy analysis project a strong plus.
- MA or MS degree in Health Policy or Health Management a plus
Softrams is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, nation origin, sexual orientation, gender identity, disability or protected veteran status.
As a HUBZone certified business, we strongly encourage candidates who reside in a HUBZone area to apply. Click on the link here to check if you are in the HubZone area (http://map.sba.gov/hubzone/maps/).