Medicare Operations Analyst

📋 Description

• Analyze and interpret Medicare and Medi-Cal data to support Medicare operations, sales, and
• Conduct complex research and analysis to inform operational decisions and support departmental
• Review monthly membership reports, identify trends and discrepancies, and provide insights into
• Apply relevant Centers for Medicare & Medicaid Services (CMS) guidelines and applicable state
• Serve as a subject matter expert and liaison for internal teams and external stakeholders on
• Identify operational issues, investigate their causes, evaluate available information, and

🎯 Requirements

• A bachelor's degree in Business Administration, Healthcare Administration, Public Health, or a
• At least five years of progressively responsible experience in Medicare membership operations
• A master's degree may substitute for two years of the required experience. An equivalent
• Knowledge of CMS guidelines governing Medicare sales and enrollment.
• Understanding of Medicare Advantage enrollment processes and financial reconciliation.
• Familiarity with monthly membership reports and the ability to interpret membership data accurately.

🎁 Benefits

• Annual base salary — Zone 1: $82,000–$95,000 for typical locations including Santa Cruz, San
• Annual base salary — Zone 2: $77,000–$90,000 for typical locations including Mariposa and Merced
• Location-based compensation: The applicable pay zone depends on the work location and local labor
• Medical, dental, and vision: Health coverage options for eligible employees.
• Paid time off: Ample paid time off to support rest and personal commitments.
• Paid holidays: 12 holidays per year.