Medicare Enrollment Programs Lead

Judi Health; Charlotte (NC); Hybrid; USD 122,000 - 152,000; Full time

Job summary

Judi Health is seeking a Government Programs Enrollment Manager in a hybrid role spanning New York, Denver, and Charlotte. You will oversee Medicare enrollment and eligibility operations for EGWP, ensuring CMS compliance, timely processing, and performance management of staff in a highly matrixed organization.

You will coordinate enrollment system builds, testing, and go-live readiness while leading outreach and regulatory reporting.

Qualifications

• 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, implementation and go-live readiness, including developing business requirements and workflows.
• Provide leadership coaching and performance management 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 CMS enrollment regulations compliance and service level adherence.
• Coordinate issue resolution and corrective actions.
• Lead outreach on missing enrollment information and CMS errors.
• Lead regulatory reporting for Health Plan, State and CMS requirements.
• Collaborate cross-functionally on employer group enrollment issues and oversight.
• Support audits by federal and state agencies including documentation and remediation tracking.
• Develop compliant documentation: policies, procedures, workflows.

Job description

Judi Health is seeking a Government Programs Enrollment Manager in a hybrid role spanning New York, Denver, and Charlotte. You will oversee Medicare enrollment and eligibility operations for EGWP, ensuring CMS compliance, timely processing, and performance management of staff in a highly matrixed organization.

You will coordinate enrollment system builds, testing, and go-live readiness while leading outreach and regulatory reporting.