Medicare Membership & Eligibility Analyst (Temporary)

Central California Alliance for Health (Remote); California (MO); Hybrid; USD 46,838 - 66,124; Full time

Job summary

The Central California Alliance for Health is seeking a temporary Medicare Membership & Eligibility Analyst to support operations and ensure compliance. This remote position requires analyzing Medicare data, with a focus on enrollment processes and operational workflows.

The ideal candidate has a Bachelor's degree and at least 5 years of experience in Medicare operations. The role is hybrid, may involve in-office presence, and offers a pay range of $34.00 - $48.00 based on experience and location.

Qualifications

• 5+ years of responsible experience in Medicare membership operations.
• Ability to analyze complex data sets and present insights.
• Experience in developing operational workflows.

Responsibilities

• Support Medicare operations through data analysis.
• Conduct complex research for Medicare activities.
• Act as a subject matter expert for stakeholders.

Skills

CMS guidelines related to Medicare sales and enrollment

Medicare Advantage enrollment processes

Data analysis tools

Education

Bachelor's degree in Business Administration or related field

Master's degree may substitute for experience

Tools

CRM/enrollment systems

Job description

Medicare Membership & Eligibility Analyst (Temporary)

Remote, California.

About This Temp Position

This is a temporary position with an estimated assignment end date of December 31, 2026. The assignment length is dependent on business need and may change. The assignment is at the Alliance, but you will be an employee of a temporary employment agency that we will connect you with.

What You'll Be Responsible For

• Supports Medicare operations, sales, and enrollment functions through analysis and interpretation of Medicare and Medi-Cal data and ensures compliance with applicable state and federal regulations.
• Conducts complex research and analysis in support of Medicare Operations activities.
• Acts as a subject matter expert and liaison to internal and external stakeholders.

What You'll Need To Be Successful

• Knowledge of:
  • CMS guidelines related to Medicare sales and enrollment.
  • Medicare Advantage enrollment processes and financial reconciliation.
  • Contents and interpretation of monthly membership reports.
  • Research, analysis, and reporting methods.
  • Data analysis tools, CRM/enrollment systems, and the use of databases.
• Ability to:
  • Analyze complex data sets and present actionable insights.
  • Identify issues, gather and analyze information and data, reach logical and sound conclusions, and make recommendations for action.
  • Interpret, explain and apply applicable policies, laws, codes, regulations, and contracts.
  • Organize work, manage multiple projects, establish priorities, adjust to changing priorities, and meet deadlines.
  • Assist with the development and implementation of projects, systems, programs, policies, and procedures.
  • Develop and implement operational workflows.
• Education and Experience:
  • Bachelor's degree in Business Administration, Health Care Administration, Public Health, or a related field.
  • Minimum of five years of progressively responsible experience related to Medicare membership operations and/or enrollment eligibility.
  • Master’s degree may substitute for two years of the required experience; or an equivalent combination of education and experience may be qualifying.

Other Information

• We are in a hybrid work environment. While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected.
• In‑office or in‑community presence may be required for some positions and is dependent on business need.
• This is a temporary position and does not provide the benefits that are listed below. Temporary employees on assignment at the Alliance will be connected to a staffing agency with separate benefit options.

Compensation Information

• Zone 1 Pay Range: $36.00 - $48.00 Typical areas: Santa Cruz, San Benito, Monterey Counties, Bay Area, Sacramento, Los Angeles, and San Diego areas.
• Zone 2 Pay Range: $34.00 - $45.00 Typical areas: Mariposa and Merced Counties, Fresno area, Bakersfield, Eastern California, San Luis Obispo area, and the Central Valley (except Sacramento).

The applicable salary ranges are based on work location and are aligned to a zone according to the cost of labor in your area. All ranges are subject to change in the future. We are happy to answer any questions that you have or share the applicable pay zone for your location if it’s not one of the typical areas listed. You can reach out to [e-mail], and a member from our Talent Acquisition team will be in touch.

The posted hiring ranges represent a good‑faith estimate of what a temporary employee would be paid on this assignment. Final compensation will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferable experience related to the position, education, or training), as well as other factors (internal equity, market factors, and geographic location).

The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer.

At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.