Medicare Enrollment Programs Manager

Capital Rx; Denver (CO); Hybrid; USD 122,000 - 183,000; Full time

Job summary

Judi Health is seeking a Government Programs Enrollment Manager to oversee Medicare enrollment and eligibility operations for the EGWP line of business. You will manage day-to-day enrollment processing, ensure CMS compliance, and drive continuous improvement through audits and performance coaching.

This hybrid role with local flexibility in New York, Denver, or Charlotte offers a competitive six-figure salary across markets and opportunities to collaborate across Judi Health teams on payer data,

Qualifications

• Minimum 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 with CMS systems including HPMS and MARx.
• Experience in delegated and highly matrixed organizations.

Responsibilities

• Manage enrollment system build and program setup, implementation and go-live readiness, including developing business requirements, workflows and testing.
• Provides 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 compliance with CMS enrollment regulations and service level agreements.
• Manage issue resolution and corrective action completion.
• Perform outreach on missing enrollment information and CMS processing errors.
• Lead regulatory reporting to ensure timely and accurate reporting from internal and external resources.
• Collaborate cross functionally on employer group issues and required oversight of enrollment activities.
• Support audits with CMS and state agencies; develop compliant documentation.

Skills

Medicare enrollment operations

CMS processing guidelines

Analytical skills

Education

HS diploma or GED

Tools

HPMS

MARx

CMS portals

Job description

Judi Health is seeking a Government Programs Enrollment Manager to oversee Medicare enrollment and eligibility operations for the EGWP line of business. You will manage day-to-day enrollment processing, ensure CMS compliance, and drive continuous improvement through audits and performance coaching.

This hybrid role with local flexibility in New York, Denver, or Charlotte offers a competitive six-figure salary across markets and opportunities to collaborate across Judi Health teams on payer data,