Medicare Part D Operations Analyst

Socket.dev; Charlotte (NC); Hybrid; USD 66,000 - 82,000; Full time

Job summary

Judi Health is hiring a Government Programs Operations Analyst to ensure timely, compliant Health Plan activities supporting EGWP. The role focuses on EGWP implementation, enrollment, claims processing, and member communications under CMS regulations.

The ideal candidate will have 3+ years in Medicare Part D or EGWP, and experience in a delegated, matrixed organization. Hybrid work model with opportunities across multiple locations.

Qualifications

• 3+ years of Medicare Part D and/or EGWP experience.
• Experience with Part D enrollment, call center and member communications.
• Experience working in a delegated and highly matrixed organization.
• Strong operational acumen and analytical acumen.

Responsibilities

• Support EGWP program setup, implementation and go-live readiness across internal functions and delegate oversight.
• Monitor daily, weekly and monthly performance, KPIs and CMS compliance metrics.
• Assist with issue resolution and corrective action with related entities (FDRs).
• Oversee monthly CMS enrollment audits and semi-annual enrollment reporting.
• Oversee member services and communications through call evaluations and sample reviews.

Skills

Medicare Part D experience

EGWP experience

Call center experience

Analytical skills

Operational excellence

Education

HS diploma/GED or equivalent

Tools

HPMS

MARx

CMS systems

Job description

Judi Health is hiring a Government Programs Operations Analyst to ensure timely, compliant Health Plan activities supporting EGWP. The role focuses on EGWP implementation, enrollment, claims processing, and member communications under CMS regulations.

The ideal candidate will have 3+ years in Medicare Part D or EGWP, and experience in a delegated, matrixed organization. Hybrid work model with opportunities across multiple locations.