Medicare Enrollment Program Lead (Hybrid)

Judi Health; Denver (CO); Hybrid; USD 122,000 - 183,000; Full time

Job summary

Judi Health in the Denver area is seeking a Government Programs Enrollment Manager to lead Medicare enrollment and eligibility operations for the EGWP line. You will oversee daily processing, ensure CMS compliance, and drive continuous improvement across enrollment workflows.

This role requires 5+ years in Medicare enrollment, strong knowledge of CMS rules, and experience with HPMS and MARx. You will collaborate across the Judi Health organization on employer group issues and support audits.

Qualifications

• HS diploma or 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, implementation and go-live readiness.
• Provide leadership coaching and performance management to Government Programs Enrollment staff.
• Manage day to day Medicare enrollment and eligibility operations including premium billing.
• Oversee processing of all Medicare enrollment and disenrollment transactions.
• Ensure CMS enrollment regulations and service level agreements are met.
• Manage issue resolution and corrective action completion.
• Perform outreach on missing enrollment information and CMS processing errors.
• Lead regulatory reporting to ensure timely reporting for CMS and state agencies.
• Collaborate cross functionally on employer group issues and oversight of enrollment activities.
• Support audits by federal/state agencies with documentation and remediation tracking.
• Develop compliant documentation for policies, workflows and work instructions.

Skills

Medicare Enrollment operations

CMS regulations & processing

HPMS & MARx systems

Matrixed organization experience

Education

HS diploma/GED or equivalent experience

Tools

HPMS

MARx

Job description

Judi Health in the Denver area is seeking a Government Programs Enrollment Manager to lead Medicare enrollment and eligibility operations for the EGWP line. You will oversee daily processing, ensure CMS compliance, and drive continuous improvement across enrollment workflows.

This role requires 5+ years in Medicare enrollment, strong knowledge of CMS rules, and experience with HPMS and MARx. You will collaborate across the Judi Health organization on employer group issues and support audits.