Medicare Membership & Eligibility Analyst (Temporary)

About this role

<div class="content-intro"><p><a href="https://thealliance.health/about-the-alliance/careers/" target="_blank"><img style="max-width: 100%;" src="https://thealliance.health/wp-content/uploads/Greenhouse-Board-Banner-Graphic.jpg" width="1200"></a></p> <p><strong><span data-contrast="auto">OUR COMMITMENT TO A HUMAN HIRING PROCESS</span></strong></p> <p><span data-contrast="auto">We believe every candidate deserves thoughtful consideration. That’s why we </span><span data-contrast="auto">do not use AI or automated systems to review applications</span><span data-contrast="auto">. Every application is reviewed by a real </span><span data-contrast="none">human </span><span data-contrast="auto">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.</span><span data-ccp-props="{}"> </span></p> <p><strong>SERVICE AREA PREFERENCE</strong></p> <p><span data-contrast="auto">While we encourage all interested applicants to apply, we do give priority to those who live in</span><span data-contrast="none">,</span><span data-contrast="auto"> or near, our service counties: </span><span data-contrast="auto">Santa Cruz, Monterey, Merced, San Benito, and Mariposa</span><span data-contrast="auto">. Our mission of </span><em><span data-contrast="auto">accessible, quality health care guided by local innovation</span></em><em><span data-contrast="none"> </span></em><span data-contrast="auto">leads</span><span data-contrast="auto"> everything we do, and having team members who are connected to the communities we serve strengthens our ability to deliver on that commitment.</span><span data-ccp-props="{}"> </span></p></div><hr> <h4>ABOUT THIS TEMP POSITION</h4> <p>This is a temporary position and the length of assignment is estimated to go until <strong>December 31, 2026.</strong> 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.</p> <h4>WHAT YOU'LL BE RESPONSIBLE FOR</h4> <p>Reporting to the Medicare Operations Director, this position:</p> <ul> <li>Supports Medicare operations, sales, and enrollment functions through analysis and interpretation <br>of Medicare and Medi-Cal data and ensures compliance with applicable state and federal <br>regulations</li> <li>Conducts complex research and analysis in support of Medicare Operations activities</li> <li>Acts as a subject matter expert and liaison to internal and external stakeholders </li> </ul> <h4>WHAT YOU'LL NEED TO BE SUCCESSFUL</h4> <p>To read the full position description and list of requirements, <a href="https://thealliance.health/wp-content/uploads/Medicare_Operations_Analyst.pdf" target="_blank">click here</a>. </p> <ul> <li><strong>Knowledge of:</strong></li> <ul> <li>CMS guidelines related to Medicare sales and enrollment</li> <li>Medicare Advantage enrollment processes and financial reconciliation</li> <li>Contents and interpretation of monthly membership reports</li> <li>Research, analysis, and reporting methods</li> <li>Data analysis tools, CRM/enrollment systems, and the use of databases</li> </ul> <li><strong>Ability to:</strong> <ul> <li>Analyze complex data sets and present actionable insights</li> <li>Identify issues, gather and analyze information and data, reach logical and sound  conclusions, and make recommendations for action</li> <li>Interpret, explain and apply applicable policies, laws, codes, regulations, and contracts</li> <li>Organize work, manage multiple projects, establish priorities, adjust to changing priorities, and meet deadlines</li> <li>Assist with the development and implementation of projects, systems, programs, policies, and procedures</li> <li>Develop and implement operational workflows</li> </ul> </li> <li><strong>Education and Experience:</strong> <ul> <li>Bachelor's degree in Business Administration, Health Care Administration, Public Health, or a related field</li> <li>Minimum of five years of progressively responsible experience related to Medicare membership operations and/or enrollment eligibility </li> <li>Master’s degree may substitute for two years of the required experience; or an equivalent combination of education and experience may be qualifying</li> </ul> </li> </ul> <h4>OTHER INFORMATION</h4> <ul> <li>We are in a hybrid work environment, and we anticipate that the interview process will take place remotely via Microsoft Teams.</li> <li>While some staff may work full telecommuting schedules, attendance at…