Medicare Operations Analyst – Temporary

Worldwide Salaried Open

Job Description:

Supports Medicare operations, sales, and enrollment functions through analysis and interpretation of Medicare and Medi-Cal data and ensures compliance with applicable state and federal regulations
Conducts complex research and analysis in support of Medicare Operations activities
Acts as a subject matter expert and liaison to internal and external stakeholders

Requirements:

Knowledge of CMS guidelines related to Medicare sales and enrollment
Knowledge of Medicare Advantage enrollment processes and financial reconciliation
Knowledge of contents and interpretation of monthly membership reports
Knowledge of research, analysis, and reporting methods
Knowledge of data analysis tools, CRM/enrollment systems, and the use of databases
Ability to analyze complex data sets and present actionable insights
Ability to identify issues, gather and analyze information and data, reach logical and sound conclusions, and make recommendations for action
Ability to interpret, explain and apply applicable policies, laws, codes, regulations, and contracts
Ability to organize work, manage multiple projects, establish priorities, adjust to changing priorities, and meet deadlines
Ability to assist with the development and implementation of projects, systems, programs, policies, and procedures
Ability to develop and implement operational workflows
Bachelor's degree in Business Administration, Health Care Administration, Public Health, or a related field
Minimum of five years of progressively responsible experience related to Medicare membership operations and/or enrollment eligibility
Master’s degree may substitute for two years of the required experience; or an equivalent combination of education and experience may be qualifying.

Benefits:

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