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Medicare Business Analyst Jobs (NOW HIRING)

SmartIPlace

Business Analyst

Montgomery, AL · On-site

$45 - $50/hr

Skill 5 years of experience in MMIS or domain knowledge of Medicare, Medicaid or with a major ... The Business Analyst must also understand the contract and be able to verify the contract ...

Commence

Business Analyst

Annapolis Junction, MD · On-site

$110K - $120K/yr

The Business Analyst will support the design, development, and implementation a case management system for the Centers for Medicare & Medicaid Services. The BA will serve as the primary liaison ...

Prosum

Business Analyst

Long Beach, CA · On-site

Molina also offers a Medicare product and has been selected in several states to participate in ... Business Analyst Location: Long Beach, California Length: On-going contract (Multi-year) Interview ...

Prosum

Business Analyst

Long Beach, CA

Molina also offers a Medicare product and has been selected in several states to participate in ... Business Analyst Location: Long Beach, California Length: On-going contract (Multi-year) Interview ...

CVS Health

Medicare Product Operations Analyst

Scottsdale, AZ · On-site

$43K - $93K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

As an analyst in, Medicare Product Operations, you will play a critical role in conducting thorough ... Proficient in Medicare business applications such as GPS, STARS Central, QNXT, and Medcompass

CVS Health

Medicare Product Operations Analyst

Hartford, CT · On-site

$43K - $93K/yr

  • Medical

  • Dental

  • Vision

  • Retirement

  • PTO

As an analyst in, Medicare Product Operations, you will play a critical role in conducting thorough ... Proficient in Medicare business applications such as GPS, STARS Central, QNXT, and Medcompass

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All JobsMedicare Business Analyst Jobs

Medicare Business Analyst information

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$17

$47

$71

How much do medicare business analyst jobs pay per hour?

As of Aug 15, 2026, the average hourly pay for medicare business analyst in the United States is $47.43, according to ZipRecruiter salary data. Most workers in this role earn between $35.58 and $59.38 per hour, depending on experience, location, and employer.

What is the difference between Medicare Business Analyst vs Medicare Data Analyst?

AspectMedicare Business AnalystMedicare Data Analyst
Required CredentialsBachelor's degree, certifications like CCBA or CBAP often preferredBachelor's degree, proficiency in data analysis tools, certifications like CAP or PCAP beneficial
Work EnvironmentHealthcare organizations, insurance companies, government agenciesHealthcare providers, insurance firms, government health departments
Primary FocusAnalyzing business processes, improving Medicare services, complianceAnalyzing Medicare data sets, generating reports, data accuracy
Common Search/ComparisonMedicare Business Analyst vs Medicare Data Analyst

The Medicare Business Analyst focuses on improving Medicare processes and ensuring compliance, while the Medicare Data Analyst specializes in analyzing Medicare data to support decision-making. Both roles require similar credentials and often work within healthcare or insurance environments, but their core responsibilities differ in scope and focus.

What are the key skills and qualifications needed to thrive as a Medicare Business Analyst?

To thrive as a Medicare Business Analyst, you need strong analytical skills, knowledge of Medicare regulations, and experience in healthcare data analysis, often supported by a degree in business, healthcare administration, or a related field. Familiarity with claims processing systems, SQL, data visualization tools, and regulatory compliance software is typically required. Outstanding attention to detail, problem-solving abilities, and effective communication help you interpret complex data and collaborate with cross-functional teams. These competencies ensure accurate analysis and compliance, supporting strategic decision-making in the evolving Medicare landscape.

What are some common challenges Medicare Business Analysts face when working with cross-functional teams?

Medicare Business Analysts often collaborate with IT, compliance, and operational teams to interpret regulatory requirements and implement process enhancements. A common challenge is ensuring clear communication across groups with varying technical and regulatory expertise. Analysts must bridge gaps by translating complex Medicare guidelines into actionable project steps while managing tight deadlines and shifting priorities. Building strong relationships and fostering open dialogue are key to successfully navigating these challenges and delivering value to the organization.

What does a Medicare Business Analyst do?

A Medicare Business Analyst is responsible for analyzing and interpreting Medicare policies, regulations, and data to help healthcare organizations remain compliant and efficient. They gather business requirements, assess processes, and recommend improvements related to Medicare claims, billing, and reporting. These analysts often work closely with IT, compliance teams, and management to ensure that systems and procedures align with Medicare standards and support optimal reimbursement and patient care.
More about Medicare Business Analyst jobs

What cities are hiring for Medicare Business Analyst jobs?

Cities with the most Medicare Business Analyst job openings:

What are the most commonly searched types of Medicare Business Analyst jobs?

The most popular types of Medicare Business Analyst jobs are:

What states have the most Medicare Business Analyst jobs?

States with the most job openings for Medicare Business Analyst jobs include:

What job categories do people searching Medicare Business Analyst jobs look for?

The top searched job categories for Medicare Business Analyst jobs are:

Medicare Business Analyst jobs near you
Infographic showing various Medicare Business Analyst job openings in the United States as of August 2026, with employment types broken down into 84% Full Time, 13% Part Time, and 3% Contract. Highlights an 90% Physical, 3% Hybrid, and 7% Remote job distribution, with an average salary of $98,662 per year, or $47.4 per hour.

Lead/Senior Business Analyst - Medicare insurance

Accord Technologies Inc.

Piscataway, NJ • On-site

$94K - $121K/yr

Contractor

Re-posted 2 days ago

Job description

Title: Lead/Senior Business Analyst - Medicare insurance domain
Location: Piscataway, NJ
Position type: W2 contract
 

Role:
We are seeking an experienced Lead/Senior Business Analyst with strong expertise in the Medicare insurance domain.
The ideal candidate will have a solid understanding ofLife, Annuity, and Health insurance products and their sub-types. 
You will play a key role in analyzing business needs, documenting requirements, and supporting processes such as claims processing, claim adjudication, policy administration, new business, and underwriting to help us deliver efficient Medicare solutions.

Key Responsibilities:

  • Gather, analyze, and document detailed business requirements for Medicare, Life, Annuity, and Health insurance products and their sub-types.
  • Understand and map core processes including claims processing, claim adjudication, policy administration, new business setup, and underwriting workflows.
  • Collaborate with stakeholders like claims teams, underwriters, policy administrators, and compliance officers to ensure business needs are met. 
  • Translate business requirements into clear, detailed functional specifications, workflows, and use cases. 
  • Identify opportunities to improve processes, workflows, and systems for better efficiency and compliance.
  • Support the design, testing, and implementation of new or enhanced systems and processes.
  • Ensure all solutions adhere to Medicare regulations, industry standards, and best practices.
  • Act as a liaison between technical teams and business units, facilitating effective communication.
  • Provide expertise on claim workflows, policy lifecycle management, underwriting, and product features.
  • Assist in User Acceptance Testing (UAT), stakeholder training, and rollout activities.
  • Keep up-to-date with industry trends, regulatory changes, and best practices in Medicare and insurance domains.
  • Collect and analyze business requirements from stakeholders, including healthcare providers, insurance companies, and regulatory bodies.
  • Identify areas for operational efficiency and recommend improvements in healthcare insurance processes.
  • Analyze healthcare and insurance data to identify trends, risks, and opportunities for cost savings and quality enhancement.
  • Create detailed documentation such as business requirements, functional specifications, and process flows.
  • Ensure that insurance processes comply with healthcare regulations and standards such as HIPAA.
  • Act as a liaison between technical teams, management, and external stakeholders.
  • Assess the effectiveness of new insurance products, systems, and processes.
  • Support project planning, execution, and monitoring activities related to healthcare insurance projects.
  • Assist in the integration of new healthcare insurance systems and technologies. 

Qualifications:

  • Bachelor’s or Master’s degree in Business, Healthcare, Insurance, or related fields.
  • Proven experience as a Business Analyst in the Medicare insurance domain or similar healthcare insurance sectors.
  • Good understanding of Life, Annuity, and Health insurance products and their sub-types.
  • Hands-on experience with claims processing, claim adjudication, policy management, underwriting, and new business processes.
  • Knowledge of Medicare regulations, policies, and compliance requirements.
  • Experience working with insurance management systems and core platforms.
  • Develop use cases, user stories, and functional specifications for system development.
  • Strong understanding of healthcare insurance processes, policies, and regulations (e.g., HIPAA).
  • Excellent analytical, problem-solving, and critical-thinking skills.
  • Proficiency in requirements gathering, process modeling, and documentation.
  • Experience with healthcare data analysis and reporting tools.
  • Familiarity with healthcare IT systems, Electronic Health Records (EHR), and insurance management software.
  • Strong interpersonal and communication skills to liaise with stakeholders at all levels.
  • Project management skills and familiarity with Agile/Scrum methodologies are advantageous. 

Preferred Skills:

  • Business Analysis certifications (CBAP, CCBA, or equivalent). 
  • Experience with Agile/Scrum methodologies.
  • Proficiency in data analysis, reporting, and process modeling tools.
  • Strong stakeholder management and presentation skills.