Senior Medicare PBP Specialist (65679)

Job Details

Remote Type

Fully Remote

Position Type

Full Time

Description

Curana Health is a provider of value-based primary care services for the senior living industry, including skilled nursing facilities, assisted & independent living communities, Memory Care units, and affordable senior housing sites. Our 1,000+ clinicians serve more than 1,500 senior living community partners across 33 states, and Curana participates in various innovative CMS programs (including owned-and-operated Accountable Care Organizations and Medicare Advantage plans). With rapid year-over-year growth since our founding in 2021, Curana is setting a new standard in innovative care delivery for seniors with high-risk, complex clinical needs, many of whom have been historically underserved by the health care system. Our mission: To radically improve the health, happiness and dignity of senior living residents.

Position Overview: We are seeking an experienced Senior Medicare PBP Specialist to support company growth and expansion initiatives through management and completion of the plan benefit packages (PBP) for the Medicare Advantage Part D Plan business. This position reports directly to the Manager, Product Development and will be responsible for implementing benefit design changes into the PBP module, managing version control, performing PBP submissions, and managing the Bid PBP desk review process. This role will be part of the Product Development team and assist with other department projects throughout the year.

Location: Position is Remote.

Key Responsibilities

• Implement benefit changes into the PBP module accurately during the CMS bid project for each MAPD product.
• Performing PBP annual submissions.
• Managing the Bid PBP desk review process.
• Organize and manage multiple detailed tasks and assignments, as well as competing deadlines with frequently changing priorities.
• Interdepartmental Alignment: Collaborate effectively with internal stakeholders, including health plan management, operations, and other relevant teams.
• Compliance and Regulatory Oversight: Ensure PBP compliance with relevant regulatory and CMS bid requirements.
• Assist with Product Development team projects and initiatives throughout the year as assigned.
  
  
  

Preferred Qualifications

• Bachelor's degree.
• Master’s degree in Healthcare Administration, or a related field.
• 5+ years of experience in PBP development, Medicare health plan industry, CMS bid submission, or related field.
• Ability to manage multiple priorities and deadlines effectively.
• Exceptional communication and interpersonal skills, with the ability to collaborate cross-functionally and build relationships with internal and external stakeholders.
  
  
  

Curana Health is dedicated to the principles of Equal Employment Opportunity. We affirm, in policy and practice, our commitment to diversity. We do not discriminate on the basis of actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth and related medical conditions), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, physical or mental disability, protected medical condition as defined by applicable or state law, genetic information, or any other characteristic protected by applicable federal, state and local laws and ordinances.

The EEO policy applies to all personnel matters as outlined in our company policy including recruitment, hiring, transfers, and general treatment during employment.