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Medicare Business Analyst Jobs (NOW HIRING)

Prosum

Business Analyst

Long Beach, CA

Molina also offers a Medicare product and has been selected in several states to participate in ... Molina Healthcare's subsidiary, Molina Medicaid Solutions (MMS), provides business processing and ...

Prosum

Business Analyst

Long Beach, CA · On-site

Molina also offers a Medicare product and has been selected in several states to participate in ... Molina Healthcare's subsidiary, Molina Medicaid Solutions (MMS), provides business processing and ...

Kanak Elite Services Inc

Sr. Business Analyst

Grand Rapids, MI · On-site

$88K - $114K/yr

We're looking for a Risk Adjustment Business Analyst with strong expertise in CMS regulations, Medicare Advantage, and compliance-driven program execution. The ideal candidate will combine regulatory ...

Zing Health Holdings

Sr. Business Analyst

Chicago, IL · On-site

$95K - $123K/yr

COMPANY OVERVIEW Zing Health is a tech-enabled insurance company making Medicare Advantage the best ... The Sr. Business Analyst will be responsible for gathering, analyzing and documenting business ...

Zing Health Holdings, Inc.

Sr. Business Analyst

Chicago, IL · On-site

$95K - $123K/yr

COMPANY OVERVIEW Zing Health is a tech-enabled insurance company making Medicare Advantage the best ... The Sr. Business Analyst will be responsible for gathering, analyzing and documenting business ...

Independent Living Systems

Senior Business Analyst

Miami, FL · On-site

$88K - $114K/yr

Proficient knowledge of UB04 / CMS-1500 claim adjudication process, including Medicare and Medicaid ... Strong proficiency in business analysis tools and methodologies, including requirements gathering ...

Tandym Tech

Business Analyst - Model N

Cambridge, MA · On-site

A nationally recognized biotech organization is seeking a Business Analyst in the United States to ... Understanding of Medicaid, Medicare, 340B, AMP, BP, and government pricing regulations * Experience ...

IPS Technology Services

Business Analyst, Sr.

Detroit, MI

$91K - $118K/yr

Business Analyst, Sr. Detroit, MI 5 months with possible extension RESPONSIBILITIES: With general ... of the Medicare Advantage and Prescription Drug Program. Audit coordination is the interface ...

Partner with PPHP

Pharmacy Business Analyst

The Pharmacy Business Analyst for our Medicare Advantage Plan will play a critical role in analyzing pharmacy data and supporting the development and implementation of pharmacy benefit strategies.

IPS Technology Services

Business Analyst, Sr.

Detroit, MI · On-site

$91K - $118K/yr

Business Analyst, Sr. Detroit, MI 5 months with possible extension RESPONSIBILITIES: With general ... of the Medicare Advantage and Prescription Drug Program. Audit coordination is the interface ...

HealthEdge

Sr. Business Analyst

$92K - $119K/yr

The Business System Analyst (BSA) will help in capturing the business requirements to run the ... Knowledgeable in Healthcare insurance domain (Medicare, Medicare Advantage, Medicaid, ACA or ...

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Medicare Business Analyst information

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How much do medicare business analyst jobs pay per hour?

As of Aug 16, 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.

Medicare Perf. Mgmt. & Transformation Dir.

EmblemHealth

New York, NY • On-site

$113K - $210K/yr

Full-time

Re-posted 24 days ago

EmblemHealth rating

9.2

Company rating: 9.2 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

21st of 308 rated insurance

Job description

Summary of Position
  • Lead Medicare performance management by connecting strategy and execution; and integrating data, insights, and execution across financial, operational, quality, and growth dimensions.
  • Translate complex analytics into clear priorities, executive-ready insights, and actionable recommendations to support strategic and operational decision-making.
  • Serve as a key partner in the development and execution of Medicare strategy - shaping priorities, investments, and longterm direction.
  • Drive performance improvement and remediation through structured governance, performance reporting (KPIs, dashboards), and disciplined execution across functional teams.
  • Ensure the Medicare business is financially sound, operationally reliable, compliant and market competitive.

Principal Accountabilities
  • Lead Medicare Performance Management & Reporting: define, monitor and evolve Key Performance Indicators (KPIs) and develop enterprise dashboards and scorecards aligned to Medicare segment goals and establish transparent reporting to communicate goals and execution across the organization.
  • Drive Performance Improvement & Remediation: conduct gap analyses; identify root causes; partner with functional teams to design, prioritize, and track remediation initiatives with measurable outcomes.
  • Develop Executive Insights & Presentations: translate complex analyses into clear, concise executive-level presentations, including risks, opportunities and recommendations.
  • Lead Cross-Functional Execution & Governance; chair performance governance forums; align stakeholders; establish priorities; develop project plans and ensure milestone tracking, accountability and delivery of results.
  • Provide Strategic Execution Support Across Priority Gaps: flex into high-priority areas requiring additional leadership or analytical support; rapidly assess issues and drive execution to address performance or capability gaps.
  • Build Strategic & Prioritization Frameworks: support strategy development through strategic assessments, prioritization frameworks, and structured evaluation of initiatives and investments.
  • Support Sales, Product & Competitive Performance Analysis: evaluate sales channel performance, enrollment forecasting, product competitiveness, and market positioning to inform growth and product strategy.

Qualifications
Education, Training, Licenses, Certifications
  • Bachelor's degree in business, Finance, HealthCare Administration, or related field; master's (MBA) preferred.
  • Project Management certification (PMI) preferred.

Relevant Work Experience, Knowledge, Skills, and Abilities
  • 10 - 12+ years of progressive experience in healthcare, with increasing scope and responsibility.
  • 5+ years of Medicare experience (products, regulations, economics, competitors).
  • 4+ years in management consulting or equivalent structured problem-solving environment.
  • Deep understanding of Medicare P&L and key performance drivers.
  • Experience across Medicare product types (MA, SNP, EGWP, PDP, Med Supp).
  • Proven ability to develop and effectively utilize tables, dashboards, and performance scorecards.
  • Experience conducting gap analysis, performance diagnostics, and strategic assessments.
  • Experience developing prioritization frameworks and business cases.
  • Strong financial acumen including P&L tracking and enrollment forecasting.
  • Experience leveraging internal and external data sources (e.g., CMS data, trend reports, primary and secondary research) to drive actionable insights.
  • Ability to translate complex data into clear, decision-ready insights for executive audiences.
  • Proven ability to lead complex, cross-functional initiatives with project plans and milestone tracking.
  • Strong communication and storytelling skills; ability to influence at all levels.
  • Ability to operate effectively in a matrixed organization without direct authority.
  • Experience managing people, processes, or project teams.
  • Advanced proficiency in Excel.
  • Experience with Access, SQL, or similar data tools.
  • Expertise in PowerPoint and executive-level presentation development.
  • Enthusiasm for engaging with AI solutions (e.g., Co-Pilot) to enhance and expedite all deliverables.

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