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$34/hr–$48/hr
Temporary
bachelor degree, postgraduate degree
Medical Plans, Dental Plans, Vision Plans, Paid Time Off, Paid Holidays, 401(a) Retirement Plan
Posted 31d ago
~40 hrs/week
Responsibilities
Supports Medicare operations, sales, and enrollment through the analysis of Medicare and Medi-Cal data to ensure regulatory compliance. Acts as a subject matter expert and liaison for internal and external stakeholders while conducting complex research.
Requirements
Requires a Bachelor's degree in Business, Health Care Administration, or Public Health, and at least five years of experience in Medicare membership operations. Candidates must be proficient in CMS guidelines, data analysis tools, and the ability to interpret complex policies.
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 innovationleads 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).
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.
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
Join us at Central California Alliance for Health (the Alliance) is an award-winning regional Medi-Cal managed care plan that provides health insurance for children, adults, seniors and people with disabilities in Mariposa, Merced, San Benito and Santa Cruz counties. We currently serve more than 418,000 members. To learn more about us, take a look at our Fact Sheet.
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.
Related keywords
MedicareMedi-CalCMS GuidelinesMedicare AdvantageEnrollment EligibilityFinancial ReconciliationCRMData AnalysisHealthcare AdministrationComplianceMembership ReportsOperational WorkflowsPublic HealthManaged Care Plan
Accessible, quality health care guided by local innovation.
Industry
Hospitals and Health Care
Company size
501-1,000 employees
Founded
1996
Headquarters
Scotts Valley, CA
LinkedIn followers
12,961
Central California Alliance for Health (the Alliance) is an award-winning regional Medi-Cal managed care plan that provides health insurance for children, adults, seniors and people with disabilities in Mariposa, Merced, Monterey, San Benito and Santa Cruz counties. We currently serve more than 434,000 members.
Founded in 1996, the Alliance was established to improve access to health care for lower income residents. We have pursued this mission by linking members to primary care physicians and clinics who assist in managing their care.
Our vision is: Healthy People. Healthy Communities. That vision remains at the forefront of the work we do every day. Come join our team!
Offices: 1600 Green Hills Road, Ste 101, Scotts Valley, CA 95066, US · 530 West 16th Street, Ste B, Merced, CA 95340, US · 950 East Blanco Road, Ste 101, Salinas, CA 93901, US · 5362 Lemee Lane, Mariposa, CA 95338, US · 1111 San Felipe Road, Suite 109, Hollister, CA 95023, US
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