Pay: $100,000-$110,000 per year
Hours: Monday-Friday 8 am-5 pm
Location: Hybrid- 1 day in office
Position Summary: We are seeking an experienced Manager, Medicare Enrollment & Reconciliation to lead Medicare Advantage enrollment operations, CMS MARx processing, payment reconciliation, compliance, and audit activities. This role will oversee a team while ensuring accurate enrollment data, regulatory compliance, and operational excellence.
Responsibilities:
- Manage Medicare Advantage enrollment and reconciliation processes.
- Oversee CMS MARx transactions, retroactive adjustments, and discrepancy resolution.
- Ensure compliance with CMS regulations, enrollment policies, and audit requirements.
- Lead payment reconciliation efforts between internal systems, CMS, and vendors.
- Develop team performance, provide coaching, and support staff development.
- Partner with cross-functional teams to resolve enrollment and eligibility issues.
- Identify process improvements and implement operational best practices.
Requirements:
- Bachelor's degree or equivalent experience.
- 4+ years of Medicare Advantage Enrollment experience within a health plan.
- 2+ years of enrollment/reconciliation leadership or supervisory experience.
- Expert knowledge of CMS enrollment regulations, MARx processing, and reconciliation.
- Strong leadership, analytical, and communication skills.
- Advanced Microsoft Excel, Word, and PowerPoint proficiency.
- Market Prominence experience preferred.
#INDAH
Pay: $100,000.00 - $110,000.00 per year
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Vision insurance
Experience:
- Medicare Enrollment: 4 years (Required)
- Reconciliation: 2 years (Required)
- Leadership/Manager: 2 years (Required)
Location:
- Huntington Beach, CA 92647 (Required)
Work Location: Hybrid remote in Huntington Beach, CA 92647
