Remote Medicare Operations Analyst - Data-Driven Enrollment

Jobgether; California; Remote; USD 120,000 - 160,000; Full time

Benefits offered by this job

Health coverage

Paid time off

Paid holidays

401(a) plan

457 plan

Job summary

Jobgether is seeking a Medicare Operations Analyst to support Medicare operations, sales, and enrollment through data analysis, regulatory interpretation, and process improvement. The role emphasizes accurate reporting, regulatory compliance, and generating actionable recommendations for enrollment workflows in a remote setup based in California.

Ideal candidates bring 5+ years in Medicare membership operations, familiarity with CMS guidelines, and strong analytical and project-management skills

Qualifications

• Requires a bachelor’s degree in Business Administration, Healthcare Administration, Public Health, or a related field.
• Five or more years of Medicare membership operations, enrollment eligibility, or similar experience.
• Knowledge of CMS guidelines for Medicare sales and enrollment.
• Understanding of Medicare Advantage enrollment processes and financial reconciliation.
• Ability to interpret membership data and produce actionable insights.

Responsibilities

• Analyze and interpret Medicare and Medi-Cal data to support operations, sales, and enrollment.
• Conduct complex research and analyses to inform decisions and initiatives.
• Review monthly membership reports; identify trends and discrepancies; provide insights on enrollment performance and reconciliation.
• Apply CMS guidelines and state/federal regulations to Medicare sales and enrollment activities.
• Serve as SME and liaison for internal teams and external stakeholders on Medicare operations.
• Support development and implementation of projects, systems, programs, policies, and procedures.
• Manage multiple projects with competing priorities; meet deadlines in a dynamic environment.
• Communicate analytical findings and recommendations clearly to inform decisions and drive improvement.

Skills

Analytical thinking

Problem solving

Communication

Project management

Stakeholder management

Data analysis

Education

Bachelor's degree in Business Administration, Healthcare Administration, Public Health

Tools

MarketProminence

Job description

Jobgether is seeking a Medicare Operations Analyst to support Medicare operations, sales, and enrollment through data analysis, regulatory interpretation, and process improvement. The role emphasizes accurate reporting, regulatory compliance, and generating actionable recommendations for enrollment workflows in a remote setup based in California.

Ideal candidates bring 5+ years in Medicare membership operations, familiarity with CMS guidelines, and strong analytical and project-management skills