Medicare Compliance Analyst - HYBRID + Department: HA - Compliance & Risk Mgmt + Entity: Health Alliance + Job Category: Professional + Employment Type: Full - Time + Job ID: 46346 + Experience Required: 1 - 3 Years + Education Required: Not Indicated + Shift: Day + Location: Champaign, IL + Usual Schedule: M-F, 8-5 + On Call Requirements: No + Work Location: HA at The Fields + Weekend Requirements: No + Holiday Requirements: No Email a Friend Save Save Apply Now Position Summary: The Medicare Compliance Analyst is responsible for understanding, researching, interpreting, communicating and answering questions on statutory requirements, regulatory requirements, and Centers for Medicare and Medicaid Services (CMS) related to the Medicare line of business. This position is responsible for development of member materials, and the review and approval of marketing and other materials related to these products. This position will also conduct ongoing monitoring and auditing of operational areas related to the Medicare lines of business. Qualifications: EDUCATIONAL REQUIREMENTS Bachelors Related Field or Two (2) years of experience in healthcare compliance or health insurance will be considered in lieu of degree. CERTIFICATION & LICENSURE REQUIREMENTS None specified. EXPERIENCE REQUIREMENTS Two (2) years experience in compliance or health insurance with previous Medicare Advantage, or Part D experience. SKILLS AND KNOWLEDGE Knowledge of Medicare regulations and CMS guidelines. Ability to research specific internet web sites to obtain answer to questions. Analytical aptitude with excellent verbal and written communication skills required. Self motivated and accountable for project coordination and follow-through. Organizational and planning skills required. Must meet deadlines and produce accurate work product. Must be able to handle multiple tasks at the same time and work well independently. Proficient in Microsoft office products (i.e., Word, Excel, Access, PowerPoint and Outlook). Essential Functions: + Monitors legislative activity and CMS publications related to the Medicare line of business. + Prepares updates, analysis and guidance, and serves as the subject matter expert to Health Alliance staff on Medicare laws, regulations and CMS guidelines. + Implements tasks/action plans and evaluates responses and supporting documentation to ensure compliance with Medicare laws, regulations and CMS guidelines. + Researches specific websites in order to answer questions related to Medicare lines of business. + Writes/develops and maintains compliance related materials (i.e. certificate of coverage, description of coverage worksheet) per the appropriate statute, regulation or CMS guidelines. + Reviews, approves and submits all Medicare member and marketing materials per CMS guidelines. + Conducts ongoing monitoring and audits of operational areas. We are an Equal Opportunity Employer and do not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class. Carle Health participates in E-Verify and may provide the Social Security Administration and, if necessary, the Department of Homeland Security with information from each new employee's Form I-9 to confirm work authorization. | For more information: human.resources@carle.com. Effective September 20, 2021, the COVID 19 vaccine is required for all new Carle Health team members. Requests for medical or religious exemption will be permitted.