Medicare Policy Analyst

About the position Peraton is seeking a strong Medicare Policy Analyst with expertise in Medicare Advantage and/or Part D data and policy. This role is part of a collaborative and agile team that builds modern, standards-based responsive solutions for CMS mission-critical health programs that support Medicare beneficiaries. In this role, you will use your skills to provide Medicare data-driven policy expertise supporting an effort to develop information systems that serve a critical role in the daily operations and high-profile initiatives of the Medicare Advantage (MA) and Prescription Drug (Part D) programs. You will provide data management, statistical analyses, project management, and other research activities in health policy, and use advanced research skills to perform a variety of research and systems development activities.

Responsibilities

• Uses expertise in MA and/or Part D to drive the business requirements and demonstrates this expertise in client-facing requirements development sessions.
• Producing summary report(s) that integrate policy and data analyses, identify current gaps in in the application, present refined prototypes and reports detailing incorporation of policy within the current program, and give options to further address policy issue(s).
• Develops and executes analytic plans and interprets complex analyses.
• Combines data from multiple sources to derive conclusions, measures and recommendations.
• Communicates analysis of CMS policy and regulations to the team. Keeps up to date with CMS guidance changes. Anticipate effects on the system of regulatory or policy changes. Understands and interprets guidance as it applies to the development effort and makes recommendations to incorporate necessary changes into the business requirements.
• Works with product managers, product owners, system architect, business analysts, and full- stack developers to resolve client issues.
• Maintains familiarity with the various MA and/or Part D plan designs, including operations, annual requirements, benefit setups, pharmacy networks, claims adjudication and/or formulary.
• Relies on experience, judgment and systems knowledge to accomplish goals.
• Leads communication of policy with various internal and external stakeholders throughout the team. Demonstrates exceptional presentation skills; prepares presentations and presents information to client and team.

Requirements

• Master degree with 6 years or Bachelor’s degree with 8 years
• Knowledge of Healthcare, Medicare Advantage and/or Part D data and policy
• Expertise with Agile tools like JIRA, Confluence, Slack etc.
• 3 years of experience in capturing requirements, and experience along all phases of agile software development
• Excellent oral and written communication skills
• Must be able to communicate to management, peers, and customers effectively and professionally as well as demonstrate sound judgment/reasoning skills
• Experience with manual and automated testing of software products
• Ability to work fully remote
• Ability to enjoy working in a fast-paced environment
• Ability to obtain a U.S. Federal Position of Trust clearance designation.
• Must reside in and be able to perform work in the United States.
• US Citizenship or Green Card holder required. Nice-to-haves
• Degree in Public Health
• Agile certifications such as Certified Scrum Product Owner or SAFe Product Owner are a plus.

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