Medicare Membership & Eligibility Analyst

ABOUT THIS TEMP POSITION

This is a temporary position and the length of assignment is estimated to go until December 31, 2026. The length of the assignment is always dependent on business need and dates may change. While the assignment would be at the Alliance, if selected, you would be an employee of a temporary employment agency that we would connect you with.

WHAT YOU'LL BE RESPONSIBLE FOR

Reporting to the Medicare Operations Director, this position:

• 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

To read the full position description and list of requirements, click here. 

• 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, and we anticipate that the interview process will take place remotely via Microsoft Teams.
• 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. Details about this can be reviewed during the interview process.
• This is a temporary position and does not provide the benefits that are listed below (this is standard language from our regular job posts and cannot be altered or removed). 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 in Zone 1: Santa Cruz, San Benito, and Monterey Counties, Bay Area, Sacramento, Los Angeles and San Diego areas
  
  
• Zone 2 Pay Range: $34.00 - $45.00
  Typical areas in Zone 2: Mariposa and Merced Counties, Fresno area, Bakersfield, Eastern California, San Luis Obispo area, and the Central Valley (except Sacramento)