Part D Subject Matter Expert

About the role

DCCA is a veteran-owned IT business specializing in providing innovative solutions to a variety of government agencies and commercial enterprises since 1982. DCCA is proud to offer career growth opportunities and a competitive compensation and benefits package.

Responsibilities

• Serve as a Part D Subject Matter Expert providing detailed operational and technical guidance on E1 eligibility queries, FIR reporting, and TrOOP balance transfer processing across the Part D Transaction Facilitator platform
• Support quality assurance for the E1 eligibility environment, including application of minimum matching criteria and management of pharmacy exclusion tables
• Analyze and resolve complex transaction processing issues related to E1, FIR, TrOOP, and BIN/PCN routing, working directly with plan sponsors, pharmacies, and other payers/switches
• Serve as a technical resource to the Program/Deputy Program Manager and support CMS workgroup discussions on Part D COB operational matters
• Aid in monthly and quarterly reporting related to E1, FIR, and missing 4Rx data as required under the QASP performance framework

Requirements

• Proven experience: Hands-on, detailed operational experience with E1 eligibility transactions, FIR reporting, and TrOOP balance transfer processing within the Medicare Part D COB program
• Working knowledge of NCPDP E1 transaction standards, matching criteria, and BIN/PCN routing
• Analyzing and resolving complex pharmacy claims and eligibility transaction issues
• Serving as a Systems Analyst, Senior Systems Analyst, or Subject Matter Expert supporting a Medicare Part D eligibility, COB, or transaction facilitation platform

Qualifications

• Bachelor's Degree preferred (Health IT, Information Systems, Business, or related field)

Skills

• Proven experience with: NCPDP standard pharmacy transactions (E1 and related transaction sets)
• Business Analysis, System Analysis, or similar function on a Part D contract that deals with E1, FIR, etc. transaction types

Benefits

• Competitive Compensation: While salary at DCCA is determined by various factors, we are committed to making sure our salaries reflect the skill and expertise of our employees. In addition, each year we perform an annual salary review ensuring pay is equitable across both the company and industry at large.
• Growth Opportunities: DCCA makes it a priority to help you grow and support your career advancement. From upskilling programs to recertification support, to professional development opportunities, we’re here to help you grow your career and create lasting relationships.
• Emphasis on Inclusivity: DCCA’s culture emphasizes respect, equity, and opportunity and is supported by an array of business resource groups and other opportunities for connection.
• Empowering Health: DCCA’s benefits which encompass healthcare, paid time off, and flexible 401(k) options encourage you to live a healthy and fulfilling life, both in and outside of work.

Pay

The proposed salary range for this position in Maryland is $140,000 to $250,000. Final salary will be determined based on various factors.

Schedule

Our comprehensive benefit offerings include healthcare, retirement plan, paid disability and life insurance programs, employee assistance program, paid and unpaid leave programs, education assistance, and wellness initiatives.