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KPMG is currently seeking a Calculations and Claims - Operations to join our Advisory Services practice.
Assist Calculation and Claims Managers on KPMG's Government Programs Managed Services service while supporting day to day client relationship and perform various tasks for ongoing monthly and quarterly operations activities related to Government Programs calculations and claims processing
Execute on client engagements focusing on business processes and risk mitigation in areas such as service, delivery and operations, third party management, data management, application management and service continuity management amongst others
Work directly with the client, Operations Managers, and engagement teams to provide ongoing pricing and claims deliverables each month and quarter, reviews Methodologies, Policies and Procedures, reporting requirements for the client and identify risk and controls gaps and provide sustainable solutions for executing risk mitigation project in accordance with the engagement and engagement team
Support and manage various tasks related to the day to day processes and ensure documents as part of the ongoing process are audit ready and in accordance with the engagement and KPMG standards
Work in a team to perform quality control checks for peers, as needed and manage dispute resolution and recalculation processing; Prepare and support the delivery of monthly and quarterly results and deliverables to the client acting backup for Claims Manager for various clients, as needed and be able to work with others in the firm for various system enhancements, as needed to support Managed Services area
Ensure the accuracy of the results based on the analysis associated with the customer data, methodology, systems and data reconciliations; confirm maintenance of system data (i.e. Customer master, product master) are up to date with various government reporting systems and client intake files
Minimum three years of experience in a client facing and or supportive role in one of the following disciplines: Accounting, Finance or Contract Operations; Basic SQL experience of reading and writing code is a plus
Bachelor's degree in an appropriate field from an accredited college/university
Experience in one of the following areas for pharmaceutical products within either the pharmaceutical industry or a consulting firm a plus: Government Price Reporting (including policy and SOP development), Government Pricing Methodologies for both branded and generic pharmaceutical products, Government Medicaid and Tricare Claims processing, or Federal Supply Schedule negotiation and maintenance
Ability to manage various projects and tasks with minimal supervision having tight deadlines as an individual contributor as well as team player
Strong attention to detail and high level of proficiency in Microsoft programs
Travel may be up to 50-75% working with various clients and internal stakeholders
KPMG LLP (the U.S. member firm of KPMG International) offers a comprehensive compensation and benefits package. KPMG is an affirmative action-equal opportunity employer. KPMG complies with all applicable federal, state and local laws regarding recruitment and hiring. All qualified applicants are considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other category protected by applicable federal, state or local laws. The attached link contains further information regarding the firm's compliance with federal, state and local recruitment and hiring laws. No phone calls or agencies please.