Medicare Membership & Eligibility Analyst (Temporary)
$74,880–$99,840 year
HybridMerced, California, United States or Salinas, California, United States
Job Summary
Support Medicare operations, sales, and enrollment functions by analyzing and interpreting Medicare and Medi-Cal data to ensure compliance with state and federal regulations. Conduct complex research and analysis to support operations activities while acting as a subject matter expert and liaison to internal and external stakeholders. Interpret CMS guidelines, enrollment processes, and monthly membership reports to present actionable insights and develop operational workflows. Manage multiple projects, establish priorities, and meet deadlines while assisting with the implementation of systems, programs, and policies. This temporary assignment ends December 31, 2026, with a salary range of $34–$48 USD depending on location.
Required Qualifications
- 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
Desired Qualifications
- Master's degree
- Two years of experience (substitutable for Master's degree)
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