Government Programs Specialist

A company is looking for a Government Programs and Services (GPS) Specialist I.

Key Responsibilities

Support MedAccess adjudication processes and communicate CMS guidance changes to clients

Provide internal and external support to ensure compliance with regulations and resolve client-specific claims issues

Maintain familiarity with client plan designs and benefit setups while managing project activities for timely service delivery

Required Qualifications

Bachelor's degree or equivalent combination of education and experience, along with 2+ years in a related industry

Familiarity with regulatory agencies and CMS guidance preferred

Intermediate knowledge of MS Office Suite and databases

Understanding of CMS, State and Federal regulations, and claim processing concepts

Experience in PBM, pharmaceutical, or managed healthcare industry is a plus