Medicare Operations Analyst

Central California Alliance for Health

. Support Medicare operations, sales, and enrollment functions through analysis and interpretation of Medicare and Medi-Cal data .

Posted 10/27/2026full-timeRemote • California • United StatesMid-LevelSenior💰 $77,000 - $95,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Medicare operations, compliance with CMS guidelines, and data analysis to support enrollment processes. Capable of developing operational workflows and managing multiple projects while ensuring adherence to state and federal regulations.

Highest-signal resume keywords

Medicare OperationsCMS GuidelinesData Analysis ToolsProject DevelopmentFinancial Reconciliation

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Data AnalysisResearch MethodsReporting MethodsOperational WorkflowsMedicare Advantage EnrollmentMembership Reports InterpretationPolicy InterpretationCompliance RegulationsEnrollment EligibilityCRM Systems

Soft Skills

Analytical ThinkingProblem SolvingOrganizational SkillsCommunication SkillsStakeholder Liaison

Industry Keywords

MedicareMedi-CalHealth Care AdministrationPublic HealthBusiness Administration

About the role

Key responsibilities & impact

Support Medicare operations, sales, and enrollment functions through analysis and interpretation of Medicare and Medi-Cal data
Ensure compliance with applicable state and federal regulations
Conduct complex research and analysis for Medicare Operations activities
Act as a subject matter expert and liaison to internal and external stakeholders
Identify issues, analyze data, reach conclusions, and recommend actions
Assist with developing and implementing projects, systems, programs, policies, and procedures
Develop and implement operational workflows

Requirements

What you’ll need

Knowledge of CMS guidelines related to Medicare sales and enrollment
Knowledge of Medicare Advantage enrollment processes and financial reconciliation
Knowledge of contents and interpretation of monthly membership reports
Knowledge of research, analysis, and reporting methods
Knowledge of data analysis tools, CRM/enrollment systems, and databases
Ability to analyze complex data sets and present actionable insights
Ability to identify issues, analyze information and data, reach logical conclusions, and make recommendations
Ability to interpret, explain, and apply policies, laws, codes, regulations, and contracts
Ability to organize work, manage multiple projects, prioritize, adjust to changing priorities, and meet deadlines
Ability to assist with developing and implementing projects, systems, programs, policies, and procedures
Ability to develop and implement operational workflows
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; equivalent combination of education and experience may qualify
Must be currently authorized to work in the United States on a full-time, ongoing basis without current or future employer sponsorship

Benefits

Comp & perks

Medical, Dental and Vision Plans
Ample Paid Time Off
12 Paid Holidays per year
401(a) Retirement Plan
457 Deferred Compensation Plan
Robust Health and Wellness Program
Onsite EV Charging Stations