Analyst, Medicare FP&A

Overview

This role involves supporting the accuracy, compliance, and operational integrity of Medicare Part D programs, including Medicare Advantage, SSIC, DSNP, and MMP programs. The Analyst will assist with monthly P2P processes, DIR Reporting, PDE Reporting, and audit support. This position requires collaboration with Compliance, Finance, Audit, Pharmacy Operations, and external stakeholders such as PBMs to resolve complex issues, strengthen controls, and ensure CMS standards adherence.

Responsibilities

• Review P2P receivables, including entering payments from other Part D contracts and tracking open receivables.
• Assist in the annual DIR Reporting process.
• Manage resolution of Acumen PDE tickets, ensuring timely and accurate responses and reporting to management.
• Coordinate with Compliance, Operational Integrity teams, and PBMs to align with evolving CMS Part D guidance.
• Synthesize complex data into clear insights for senior leadership and Compliance partners.
• Support analytical reviews related to CMS PDE submissions and reconciliation to paid claims data.
• Identify opportunities to optimize accuracy, improve internal controls, and streamline operational processes for Part D PDE submissions.
• Contribute to automation, data governance, and ETL optimization initiatives to enhance reporting efficiency and accuracy.

Requirements

• Minimum 2 years of experience in Medicare Part D accounting, financial operations, or regulatory compliance.
• Strong financial reporting and analysis skills.
• Proficiency with SAS/SQL, Python, Google Cloud Platform (GCP), and advanced data management tools.
• Ability to interpret complex datasets and translate findings into actionable recommendations.
• Strong analytical, mathematical, and problem-solving abilities.
• Bachelor’s degree in Finance, Accounting, or a related discipline, or equivalent experience.

Preferred Qualifications

• Over 2 years of Medicare Part D finance experience with expertise in data mining, analytics, and operational improvement.
• Experience supporting or leading compliance activities within a health plan or regulated environment.

Compensation & Benefits

• Typical pay range: $43,888.00 - $85,068.00 annually.
• Actual salary depends on experience, education, geography, and other factors.
• Eligibility for bonus, commission, or short-term incentive programs.
• Comprehensive benefits package including medical, dental, vision coverage, paid time off, retirement savings options, and wellness programs.

Work Schedule

• Full-time position.
• Anticipated 40 hours per week.

Location

• Not specified.