California Medicare Operations Analyst

Job Summary

Supporting Medicare operations remotely, the full-time Medicare Operations Analyst will analyze and interpret Medicare and Medi-Cal data, ensure compliance with regulations, and serve as a subject matter expert for internal and external stakeholders.

Key responsibilities

• Support Medicare operations, sales, and enrollment functions through data analysis and compliance assurance
• Conduct complex research and analysis to enhance Medicare Operations activities
• Act as a liaison and subject matter expert for various stakeholders

Required qualifications

• Bachelor's degree in Business Administration, Health Care Administration, Public Health, or a related field
• Minimum of five years of experience in Medicare membership operations or enrollment eligibility
• Knowledge of CMS guidelines and Medicare Advantage enrollment processes
• Experience with data analysis tools and CRM/enrollment systems
• Ability to analyze complex data sets and develop operational workflows