Medicare Membership & Eligibility Analyst – Temporary

This is a fully remote position, open to applicants in California.

📋 Description

• Provides support for Medicare operations, sales, and enrollment activities by analyzing and interpreting Medicare and Medi-Cal data, ensuring adherence to relevant state and federal regulations.

• Performs in-depth research and analysis to assist Medicare Operations initiatives.

• Serves as a subject matter expert and acts as a liaison to both internal and external stakeholders.

⛳️ Requirements

• Understanding of CMS guidelines pertaining to Medicare sales and enrollment.

• Familiarity with Medicare Advantage enrollment procedures and financial reconciliation.

• Insight into the contents and interpretation of monthly membership reports.

• Proficiency in research, analysis, and reporting methodologies.

• Expertise in data analysis tools, CRM/enrollment systems, and database usage.

• Capability to analyze intricate data sets and deliver actionable insights.

• Skill in identifying issues, collecting and analyzing information and data, drawing logical conclusions, and making actionable recommendations.

• Competency in interpreting, explaining, and applying relevant policies, laws, codes, regulations, and contracts.

• Ability to organize tasks, manage multiple projects, set priorities, adapt to changing demands, and meet deadlines.

• Experience in assisting with the creation and implementation of projects, systems, programs, policies, and procedures.

• Ability to develop and implement effective operational workflows.

• Bachelor's degree in Business Administration, Health Care Administration, Public Health, or a related discipline.

• At least five years of progressively responsible experience related to Medicare membership operations and/or enrollment eligibility.

• A Master’s degree may substitute for two years of the required experience; or an equivalent combination of education and experience may be acceptable.

🏝️ Benefits

• Medical, Dental, and Vision Plans.

• Generous Paid Time Off.

• 12 Paid Holidays annually.

• 401(a) Retirement Plan.

• 457 Deferred Compensation Plan.

• Comprehensive Health and Wellness Program.

• Onsite EV Charging Stations.

• And many more.