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Gallagher is a global leader in insurance, risk management and consulting services. We help businesses grow, communities thrive and people prosper. We live a culture defined by The Gallagher Way, our set of shared values and guiding tenets. A culture driven by our people, over 30,000 strong, serving our clients with customized solutions that will protect them and fuel their futures.
Position Summary:
Primarily focused on the development, maintenance, and assurance of accurate and quality reporting, analysis of pharmacy and medical benefit utilization, and cost modeling. Key accountabilities include p roviding analytical expertise in the development of pharmacy focused reporting and assessment of the impacts of benefit design changes.
Essential Duties and Responsibilities:
Unique Consultant/Specialist within an Operations & Support role. Performs functions of moderate to high level of complexity involving substantial autonomy and independent decision making. Fully knowledgeable in Medicare Part C regulatory compliance and operations for Medicare Advantage-Prescription Drug (MA-PD) Plans and capable of completing complex tasks and analyses within established guidelines. Advanced ability to review, interpret and implement Federal Guidance and perform mock Centers for Medicare and Medicaid Services (CMS) Organizational Determination, Appeals and Grievances (ODAG) and Special Needs Plan (SNP) mock Program Audits. Typically works independently, receiving minimal guidance.
Required:
