Medicare Operations Analyst

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

📋 Description

• Assist in Medicare operations, sales, and enrollment activities by analyzing and interpreting Medicare and Medi-Cal data.

• Ensure adherence to relevant state and federal regulations.

• Perform intricate research and analysis for Medicare Operations initiatives.

• Serve as a subject matter expert and point of contact for both internal and external stakeholders.

• Identify challenges, analyze data, draw conclusions, and propose actions.

• Aid in the development and execution of projects, systems, programs, policies, and procedures.

• Create and implement operational workflows.

⛳️ Requirements

• Familiarity with CMS guidelines pertaining to Medicare sales and enrollment.

• Understanding of Medicare Advantage enrollment processes and financial reconciliation.

• Knowledge of the content and interpretation of monthly membership reports.

• Acquaintance with research, analysis, and reporting methodologies.

• Proficiency in data analysis tools, CRM/enrollment systems, and databases.

• Capability to analyze complex data sets and provide actionable insights.

• Skill in identifying issues, analyzing information and data, reaching logical conclusions, and making recommendations.

• Ability to interpret, clarify, and apply policies, laws, codes, regulations, and contracts.

• Competence in organizing work, managing multiple projects, prioritizing tasks, adjusting to changing priorities, and meeting deadlines.

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

• Proficiency in developing and implementing operational workflows.

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

• 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; an equivalent combination of education and experience may qualify.

• Must be authorized to work in the United States on a full-time, ongoing basis without current or future employer sponsorship.

🏝️ Benefits

• Medical, Dental, and Vision Plans.

• Generous Paid Time Off.

• 12 Paid Holidays each year.

• 401(a) Retirement Plan.

• 457 Deferred Compensation Plan.

• Comprehensive Health and Wellness Program.

• Onsite EV Charging Stations.