Medicare Membership & Eligibility Analyst (Temporary)

About this role

OUR COMMITMENT TO A HUMAN HIRING PROCESS

We believe every candidate deserves thoughtful consideration. That’s why we do not use AI or automated systems to review applications. Every application is reviewed by a real human member of our team. Because we take the time to give each submission the attention it deserves, our review process may take a little longer — and we genuinely appreciate your patience as we work through applications carefully and respectfully.

SERVICE AREA PREFERENCE

While we encourage all interested applicants to apply, we do give priority to those who live in, or near, our service counties: Santa Cruz, Monterey, Merced, San Benito, and Mariposa. Our mission of accessible, quality health care guided by local innovation leads everything we do, and having team members who are connected to the communities we serve strengthens our ability to deliver on that commitment.

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…