GPS Specialist I

Exemption Status:
United States of America (Exempt)
$50,667 - $66,500 - $82,333
"Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate."
MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!
Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.
At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing
solutions
that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!
Job Description
GPS Specialist
$50,667 - $66,500 - $82,333
"Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors. A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate."
This position is not eligible for Sponsorship.
Summary: The GPS Specialist acts as the liaison between MedImpact clients and the Government Programs Services (GPS) department. Being well-versed in Center for Medicare and Medicaid Services (CMS), State and Federal regulations and guidance, this position supports the front-end management of various services provided by the PBM. This role actively participates and occassionally directs assignments that are complex in nature where judgement, initiative and excellent communications are required in resolving problems and positively impacting client satisfaction.
Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Communicates CMS guidance changes and updates to the clients. Keeps up-to-date with CMS guidance changes and how MedImpact implements changes in-line with state and federal guidelines.
• Provides internal and external support to ensure MedImpact and its clients adhere to processes and to ensure compliance with related regulations. Works across the organization to expeditiously resolve issues, escalate service recovery efforts and provide timely feedback.
• Ensures client comprehension of MedImpact's processes and CMS guidance.
• Explains new programs and enhancements to existing programs to clients. Communicates major file and report changes to clients by having a detailed understanding of any changes.
• Adheres to strict procedural and quality CMS standards and corporate guidelines; aids in the creation of documentation; analyzes claims while applying a thorough understanding of assigned clients' technical and service requirements.
• Works with internal departments (Information Technology, Operations Client Business Analyst and others) to resolve client specific claims issues.
• Maintains familiarity with the various plan designs, benefit setups, pharmacy networks, claims adjudication and formulary for assigned clients. Keeps the "Client Profile" updated with requisite information.
• Provides client-facing support for project Implementation and/or internal implementation support including Sales/Account Management support for Business Development.
• Provides team representation and management of client interfaces regarding specific program aspects.
• Completes project activities within the prescribed time frame to ensure timely and accurate delivery of services. Manages client expectations on issue resolution and provides customer support to address any action items/issues or problems by working proactively under strict deadlines.

Education and/or Experience
Level I
Bachelor's degree (or equivalent combination of education and experience) along with 2+ years' experience in a related industry. Good familiarity with regulatory agencies and CMS guidance a plus. Experience in PBM, pharmaceutical, or managed healthcare industry a plus.
Computer Skills
To perform this job successfully, an individual should have knowledge intermediate knowledge of MS Office Suite (Word, Excel, PowerPoint), Outlook or other email system and databases.
Certificates, Licenses, Registrations
Pharmacy Technician, not required, but preferred
Other Skills and Abilities

• Good understanding of Center for Medicare and Medicaid Services (CMS), State and Federal regulations and guidance with the ability to assimilate and keep up to date with changes.
• Possesses a cross-functional understanding of GPS processes within different departments preferred.
• Intermediate to advanced understanding of claim processing concepts.
• Strong Interpersonal skills with the ability to work effectively with differing personalities and levels of employees.
• Well defined decision-making skills, including proven problem analysis and discerning communications under pressure.
• Demonstrated business acumen combined with a strong understanding of the business processes associated with PBM service delivery.
• Able to work under tight deadlines in a results-driven department.

The Perks:

• Medical / Dental / Vision / Wellness Programs
• Paid Time Off / Company Paid Holidays
• Incentive Compensation
• 401K with Company match
• Life and Disability Insurance
• Tuition Reimbursement
• Employee Referral Bonus

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers
MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego,
California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.
Equal Opportunity Employer, Male/Female/Disabilities/Veterans
OSHA/ADA:
To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Disclaimer:
The above
statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.