Medicare Enrollment Specialist

Summary

Join the Central California Alliance for Health as a Medicare Enrollment Specialist! This role is crucial to the launch of the Alliance's first Medicare D-SNP plan in January 2026. You will be responsible for facilitating the enrollment process, working with internal and external stakeholders, and tracking enrollment data. The ideal candidate is a self-starter with experience in Medicare enrollment and a meticulous attention to detail. This position offers a unique opportunity to shape processes and workflows within a collaborative and supportive team environment. The Alliance offers a hybrid work environment and a competitive compensation package.

Requirements

• Is a self-starter
• Comfortable navigating ambiguity and works well with little direction
• Meticulously organized and has razor-sharp attention to detail
• Has experience with the Medicare enrollment process and familiarity with CMS guidelines and turnaround times related to enrollment
• Excellent interpersonal skills with emphasis on collaboration
• Knowledge of: The Medicare member enrollment process and related CMS requirements
• MHK Market Prominence Medicare Advantage member enrollment, billing, and financial reconciliation platform
• The methods and techniques of data entry
• The methods and techniques of system-generated reporting
• Windows-based PC systems, including Microsoft Word, Excel, Outlook and PowerPoint
• Ability to: Ensure that Medicare D-SNP enrollment activities comply with CMS and DHCS requirements
• Learn Medi-Cal program eligibility requirements and enrollment related regulations, the Medi-Cal Eligibility Data System (MEDS-Lite) and its HIPAA compliant portal
• Understand the interaction between Alliance systems and CMS systems
• Enter, proofread, verify, analyze, and audit data
• Produce organized, accurate, and detail-oriented work and maintain accurate records
• High School Diploma or equivalent
• A minimum of four years of experience performing Medicare member enrollments (an Associate’s degree may substitute for one year of the required experience); or an equivalent combination of education and experience may be qualifying

Responsibilities

• Facilitates the enrollment process into the Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) for those prospective dual-eligible beneficiaries by ensuring timely, compliant, and accurate enrollment processing within the enrollment and eligibility system
• Works with internal and external stakeholders to facilitate Medicare D-SNP enrollment activities
• Tracks and reports on prospective and current member enrollment data and performs other activities in support of the Medicare Operations Department’s enrollment function

Benefits

• 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