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Medicare Membership & Eligibility Analyst (Temporary)

Central California Alliance for Health -
Santa Clara, CA

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Job Details

Temporary | Full-time
$34 - $48 an hour
11 days ago

Benefits

401(a)
Wellness program
Paid holidays
Health insurance
Dental insurance
Paid time off
Vision insurance
Retirement plan

Qualifications

Financial data reconciliation
Health data analysis
Medicare
Workflow management (operations management method)
CMS
Business analysis
Databases
CMS regulatory compliance
Policy & process development
Bachelor's degree
Health insurance knowledge
Medicare regulations
Task prioritization

Full Job Description

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 quarterly company-wide events or department meetings will be expected.
In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process.
This is a temporary position and does not provide the benefits that are listed below (this is standard language from our regular job posts and cannot be altered or removed). Temporary employees on assignment at the Alliance will be connected to a staffing agency with separate benefit options.

COMPENSATION INFORMATION

Zone 1 Pay Range: $36.00 - $48.00
Typical areas in Zone 1: Santa Cruz, San Benito, and Monterey Counties, Bay Area, Sacramento, Los Angeles and San Diego areas
Zone 2 Pay Range: $34.00 - $45.00
Typical areas in Zone 2: Mariposa and Merced Counties, Fresno area, Bakersfield, Eastern California, San Luis Obispo area, and the Central Valley (except Sacramento)

The applicable salary ranges are based on work location and are aligned to a zone according to the cost of labor in your area. All ranges are subject to change in the future. We are happy to answer any questions that you have or share the applicable pay zone for your location if it's not one of the typical areas listed. You can reach out to [email protected], and a member from our Talent Acquisition team will be in touch.

The posted hiring ranges represent a good‑faith estimate of what a temporary employee would be paid on this assignment. Final compensation will be determined by our compensation philosophy, analysis of the selected candidate's qualifications (direct or transferable experience related to the position, education, or training), as well as other factors (internal equity, market factors, and geographic location).

OUR BENEFITS

Available for all regular Alliance employees working more than 30 hours per week. Some benefits are available on a pro-rated basis for part-time employees. These benefits are unavailable to temporary employees while on an assignment with the Alliance.

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

ABOUT US

We are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.

Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve members in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. To learn more about us, take a look at our Fact Sheet.

The Alliance is an equal employment opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), sexual orientation, gender perception or identity, national origin, age, marital status, protected veteran status, or disability status. We are an E-Verify participating employer

At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for any type of employer supported or provided sponsorship.

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ABOUT THIS TEMP POSITION

WHAT YOU'LL BE RESPONSIBLE FOR

WHAT YOU'LL NEED TO BE SUCCESSFUL

OTHER INFORMATION

OUR BENEFITS

ABOUT US

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