Medicare Enrollment Program Lead

Judi Health; New York (NY); Hybrid; USD 121,000 - 183,000; Full time

Job summary

Judi Health in New York, NY is seeking a Government Programs Enrollment Manager to lead Medicare enrollment operations for the EGWP line of business. You will oversee daily Medicare enrollment and eligibility processing, ensure CMS compliance, and manage oversight of enrollment activities across the organization.

The role emphasizes system builds, audits, regulatory reporting, and cross-functional collaboration with internal teams and external CMS requirements to maintain accurate, timely

Qualifications

• Minimum of HS diploma/GED or equivalent experience.
• 5+ years of Medicare Enrollment operations experience.
• Deep knowledge of Medicare enrollment regulations and CMS processing guidelines.
• Experience working within CMS systems, including HPMS and MARx.
• Experience working in a delegated and highly matrixed organization.

Responsibilities

• Manage enrollment system build and program setup, go-live readiness and testing.
• Provide leadership coaching to Government Programs Enrollment staff.
• Oversee day-to-day Medicare enrollment and eligibility operations including premium billing.
• Oversee processing of all Medicare enrollment and disenrollment transactions.
• Ensure compliance with CMS enrollment regulations and SLAs.
• Manage issue resolution and corrective action closure.
• Perform outreach on missing enrollment information and CMS errors.
• Lead monthly data validation audits and CMS responses.
• Lead regulatory reporting to meet CMS and state requirements.
• Collaborate cross-functionally on employer group enrollment issues.
• Support audits by federal and state agencies with documentation.

Skills

Medicare Enrollment operations

CMS regulations knowledge

CMS systems experience (HPMS, MARx)

Leadership coaching / staff

Matrixed organization experience

Education

HS diploma/GED or equivalent experience

Job description

Judi Health in New York, NY is seeking a Government Programs Enrollment Manager to lead Medicare enrollment operations for the EGWP line of business. You will oversee daily Medicare enrollment and eligibility processing, ensure CMS compliance, and manage oversight of enrollment activities across the organization.

The role emphasizes system builds, audits, regulatory reporting, and cross-functional collaboration with internal teams and external CMS requirements to maintain accurate, timely