Medicare Advantage Enrollment Analyst (NO C2C)
Why work at OpTech?OpTech is a woman-owned company that values your ideas, encourages your growth, and always has your back. When you work at OpTech, not only do you get health and dental benefits, but you also have training opportunities, flexible/remote work options, growth opportunities, 401K and competitive pay. Apply today! To view our complete list of openings, please visit our .Job Title: Medicare Advantage Enrollment Analyst (Enrollment & Compliance)Job SummaryWe are seeking a detail-oriented and analytical professional to support the development and execution of Medicare Advantage programs and strategies. This role focuses on using data insights to improve business decision-making, optimize workflows, and enhance operational performance across enrollment, disenrollment, and reconciliation processes. The ideal candidate will have strong CMS knowledge and experience supporting compliance-driven healthcare operations.Key ResponsibilitiesSupport the development and implementation of programs and process improvements to enhance business operationsAnalyze data to identify trends, insights, and opportunities for improved decision-makingDevelop and refine workflows to increase efficiency and service qualitySupport Medicare Advantage enrollment and disenrollment processesEnsure adherence to CMS guidelines and regulatory requirementsAssist with membership reconciliation and discrepancy resolution processesProvide responsive support to internal teams and external partnersCollaborate across teams to improve operational performance and customer experienceRequired Qualifications:Minimum 4 years of experience in the Medicare Advantage fieldExperience with Medicare Advantage enrollment/disenrollment processesFamiliarity with CMS guidelines and regulatory standardsExperience using MARx and TRR systemsStrong data analysis and reporting skillsProven ability to support internal and external stakeholdersPreferred Qualifications:Knowledge of CMS Chapter 2 guidelinesUnderstanding of CMS thresholds and compliance timelines for discrepancy resolutionExperience with employer group Medicare Advantage membership reconciliationProcess improvement experience (Six Sigma or similar methodologies)Education/Certifications:High School Diploma or equivalent OR Bachelor’s degree (preferred)OpTech is an equal opportunity employer and is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, status as a parent, disability, age, veteran status, or other characteristics as defined by federal, state or local laws. https://www.optechus.com/eeo_self_identification/