Job Title
Business Analyst – Medicare Advantage Enrollment
Location
Detroit, MI – Jefferson Office
Hybrid: Onsite Monday & Tuesday (2 days/week)
Schedule
Hybrid
Type
W2 Contract Only | 12-Months Contract to Possible Hire
Pay Rate:
$32–$35/hour (W2)
Summary
Join a MA Enrollment Operations team as a Business Analyst supporting Medicare Advantage enrollment and reconciliation activities. This role is responsible for driving process improvements, enhancing workflows, and supporting data-driven decision-making related to enrollment and disenrollment operations. The ideal candidate brings strong Medicare Advantage experience, CMS knowledge, and hands-on MARx and TRR exposure.
Key Responsibilities
- Lead development and implementation of process improvements related to Medicare Advantage enrollment and disenrollment.
- Analyze enrollment data and operational workflows to identify opportunities to improve efficiency, accuracy, and compliance.
- Support membership reconciliation activities, including MARx and TRR processing.
- Ensure alignment with CMS guidelines, compliance requirements, and timeliness standards.
- Provide support to internal business partners and external stakeholders.
- Assist with discrepancy resolution and operational issue analysis.
- Collaborate across teams to enhance products, programs, and customer experience.
Required Qualifications
- Medicare Advantage enrollment and disenrollment experience.
- Strong knowledge of CMS guidelines.
- Hands-on experience with MARx and TRR.
- Data analysis experience.
- Proven ability to support internal and external customers.
- High School Diploma required.
- Minimum 4 years of experience in the Medicare Advantage field.
Preferred Qualifications
- Knowledge of CMS Chapter 2 guidelines.
- Experience with CMS thresholds and compliance timeliness for discrepancy resolution.
- Understanding of Employer Group Medicare Advantage Membership Reconciliation processes.
- Process improvement experience (e.g., Six Sigma or similar methodologies).
- Bachelor’s degree preferred.
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