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Medicare Analyst Jobs (NOW HIRING)

Solventum

MEDICARE POLICY ANALYST

Medicare Policy Analyst (Solventum) 3M Health Care is now Solventum At Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating ...

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Medicare Analyst information

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$31K

$73.3K

$130K

How much do medicare analyst jobs pay per year?

As of Jun 9, 2026, the average yearly pay for medicare analyst in the United States is $73,261.00, according to ZipRecruiter salary data. Most workers in this role earn between $52,500.00 and $87,000.00 per year, depending on experience, location, and employer.

What is a Medicare Analyst job?

A Medicare Analyst is responsible for reviewing and analyzing Medicare claims, policies, and compliance to ensure alignment with federal and state regulations. They assess claims for accuracy, identify potential billing discrepancies, and work to optimize reimbursement processes. Additionally, they may assist in policy development, reporting, and collaboration with healthcare providers to improve efficiency and compliance in Medicare-related operations.

What are the key skills and qualifications needed to thrive in the Medicare Analyst position, and why are they important?

To thrive as a Medicare Analyst, you need strong analytical skills, attention to detail, and a solid understanding of Medicare regulations, often backed by a degree in healthcare administration, public health, or a related field. Experience with claims processing software, data analysis tools like Excel or SAS, and familiarity with CMS (Centers for Medicare & Medicaid Services) guidelines are typically important. Excellent problem-solving, communication, and time management skills enable effective collaboration and reporting. These competencies are crucial for accurately interpreting complex policies, identifying compliance issues, and supporting organizational decision-making within the evolving Medicare landscape.

What does a medicare coverage analyst do?

A Medicare coverage analyst reviews and interprets Medicare policies and regulations to determine coverage eligibility for patients. They analyze claims, ensure compliance with guidelines, and assist in resolving coverage issues, often using healthcare data management tools. Strong knowledge of Medicare rules and attention to detail are essential for this role.

What are the main responsibilities of a Medicare Analyst in a typical workweek?

As a Medicare Analyst, your main responsibilities include reviewing and analyzing Medicare claims for accuracy, ensuring compliance with government regulations, and identifying opportunities for process improvement. You might collaborate closely with billing, compliance, and clinical teams to clarify regulations and resolve discrepancies. Regular tasks also involve preparing reports, monitoring policy updates from CMS, and assisting with audits or internal reviews. The role requires balancing independent research with cross-functional teamwork to ensure the organization meets all Medicare requirements.

More about Medicare Analyst jobs
What cities are hiring for Medicare Analyst jobs? Cities with the most Medicare Analyst job openings:
What are the most commonly searched types of Medicare Analyst jobs? The most popular types of Medicare Analyst jobs are:
What states have the most Medicare Analyst jobs? States with the most job openings for Medicare Analyst jobs include:
What job categories do people searching Medicare Analyst jobs look for? The top searched job categories for Medicare Analyst jobs are:
Medicare Analyst jobs near you
Infographic showing various Medicare Analyst job openings in the United States as of June 2026, with employment types broken down into 86% Full Time, 11% Part Time, and 3% Contract. Highlights an 81% Physical, 8% Hybrid, and 11% Remote job distribution, with an average salary of $73,261 per year, or $35.2 per hour.
Actuarial Analyst - Medicare

Actuarial Analyst - Medicare

Blue Cross and Blue Shield of North Carolina

Philadelphia, PA

$81K - $129K/yr

Other

Medical, Dental, Vision, Retirement, PTO

Posted 20 days ago

Blue Cross and Blue Shield of North Carolina rating

7.8

Company rating: 7.8 out of 10

Based on 13 frontline employees who took The Breakroom Quiz

166th of 260 rated insurance

Job description

Job Description

We are seeking a motivated Actuarial Analyst to join our Medicare Pricing Team. In this role, you will apply your mathematical and statistical knowledge to support activities such as rating, valuation, healthcare economics, and financial forecasting. Guided by experienced actuaries, you will contribute to health programs and offer actuarial support across departments, including Network Management, Underwriting, Sales and Marketing, Finance, and Healthcare. This is an excellent opportunity for individuals starting their actuarial career and looking to gain broad experience in the field.

What You'll Do

  • Performs actuarial research, experience studies, and statistical analyses and calculations.

  • Calculates premiums and reserves of new and existing plans of insurance.

  • Provides support to senior analysts or actuaries as required.

  • Retrieves and validates data for rate filings and actuarial models. Builds model enhancements and determines reasons for changes to calculated factors. Analyzes impacts of changes to product lines and segments.

  • Communicates filing status to internal stakeholders and transmits rate filings to regulatory agencies (NCDOI, CMS).

  • Retrieves and validates data for monthly reports and for UCL and ALR calculation.

  • Supports valuation by executing ALR model and verifying results. Researches to support ALR assumption studies and UCL estimates.

  • Distributes established reports and responds to inquiries. Investigates trends and anomalies.

  • Executes control activities to support Enterprise Risk Management.

  • Provides analytic support for corporate and departmental projects.

  • Is a participant in good standing in the Actuarial Development Program

What You Bring

  • Bachelor's degree or advanced degree (where required)

  • 2+ years of relevant actuarial experience. Related experience may be considered.

  • Must have completed at least 3 exams towards the eventual attainment of the ASA designation.

  • In lieu of meeting minimum exam requirements, may consider additional relevant experience.

  • In lieu of meeting minimum experience requirements, may consider ASA or more exams towards the eventual attainment of the ASA.

Bonus Points

  • Previous Medicare Advantage experience a plus

  • SQL, SAS, Python experience highly preferred

What You'll Get

  • The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community.

  • Work-life balance, flexibility, and the autonomy to do great work.

  • Medical, dental, and vision coverage along with numerous health and wellness programs.

  • Parental leave and support plus adoption and surrogacy assistance.

  • Career development programs and tuition reimbursement for continued education.

  • 401k match including an annual company contribution

  • Learn more

Salary Range

At Blue Cross NC, we take great pride in a fair and equitable compensation package that reflects market-price and our starting salaries are typically planned near the middle of the range listed. Compensation decisions are driven by factors including experience and training, specialized skill sets, licensure and certifications and other business and organizational needs.Our base salary is part of a robust Total Rewards package that includes an Annual Incentive Bonus*, 401(k) with employer match, Paid Time Off (PTO), and competitive health benefits and wellness programs.

*Based on annual corporate goal achievement and individual performance.

$81,068.00 - $129,708.00

Skills

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JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Blue Cross and Blue Shield of North Carolina in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All our career opportunities are published on https://bcbsnc.wd5.myworkdayjobs.com/en-US/BCBSNC. If you have already provided your personal information that you suspect is fraudulent activity, please report it to your local authorities. Any fraudulent activity should be reported to: HR.Staffing@BCBSNC.com.

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