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Medicare Enrollment Specialist

Feasterville Trevose, PA · On-site

$15 - $20/hr

The Medicare Enrollment Specialist plays a crucial role within a larger enrollment team, focusing ... Attention to detail and effective time management * Proficient problem-solving abilities Company ...

New

HealthEdge

Medicare Enrollment Specialist II

HealthProof is looking for an Enrollment Specialist II, reporting to the Enrollment Manager. The ... A thorough understanding of Medicare Advantage products, CMS transaction files, and the ...

HealthEdge

Medicare Enrollment Specialist II

HealthProof is looking for an Enrollment Specialist II, reporting to the Enrollment Manager. The ... A thorough understanding of Medicare Advantage products, CMS transaction files, and the ...

HealthEdge

Medicare Enrollment Specialist II

HealthProof is looking for an Enrollment Specialist II, reporting to the Enrollment Manager. The ... A thorough understanding of Medicare Advantage products, CMS transaction files, and the ...

HealthEdge

Medicare Enrollment Specialist II

HealthProof is looking for an Enrollment Specialist II, reporting to the Enrollment Manager. The ... A thorough understanding of Medicare Advantage products, CMS transaction files, and the ...

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Medicare Enrollment Manager information

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$35.5K

$86.4K

$117K

How much do medicare enrollment manager jobs pay per year?

As of Aug 23, 2026, the average yearly pay for medicare enrollment manager in the United States is $86,379.00, according to ZipRecruiter salary data. Most workers in this role earn between $60,000.00 and $116,500.00 per year, depending on experience, location, and employer.

What does a Medicare Enrollment Manager do?

A Medicare Enrollment Manager oversees the process of enrolling individuals into Medicare health plans, ensuring compliance with federal regulations and organizational policies. They manage a team that processes applications, resolves enrollment issues, and communicates with members and government agencies. Their responsibilities also include monitoring enrollment trends, training staff, and implementing process improvements to enhance efficiency and accuracy. The role requires strong knowledge of Medicare guidelines and excellent organizational and leadership skills.

What are the key skills and qualifications needed to thrive as a Medicare Enrollment Manager?

To thrive as a Medicare Enrollment Manager, you need in-depth knowledge of Medicare regulations, enrollment processes, and healthcare administration, often backed by a bachelor’s degree in healthcare or a related field. Familiarity with enrollment management systems, CRM software, and compliance documentation is typically required. Strong leadership, attention to detail, and clear communication are critical soft skills for managing teams and ensuring accurate enrollment. These skills and qualities are essential to maintain regulatory compliance, optimize enrollment efficiency, and deliver excellent service to beneficiaries.

What are some common challenges faced by a Medicare Enrollment Manager, and how can they be addressed?

A Medicare Enrollment Manager often navigates complex regulatory requirements and frequent updates to Medicare policies, which can create challenges in maintaining compliance and ensuring accurate enrollment processing. Another common challenge is coordinating across multiple teams, such as customer service, IT, and compliance, to resolve enrollment issues efficiently. Staying organized, fostering open communication, and regularly participating in training on Medicare regulations can help address these challenges. Additionally, leveraging technology to track applications and monitor compliance can streamline workflows and reduce errors.

What is the difference between Medicare Enrollment Manager vs Medicare Customer Service Representative?

AspectMedicare Enrollment ManagerMedicare Customer Service Representative
CredentialsTypically requires knowledge of Medicare policies, certifications may include insurance licensesCustomer service skills, basic Medicare knowledge, possibly some certifications
Work EnvironmentOffice-based, administrative, and managerial settingsCall centers, customer support centers, or remote
Employer & IndustryHealth insurance companies, government agencies, healthcare providersInsurance companies, healthcare providers, government programs

The Medicare Enrollment Manager focuses on overseeing enrollment processes, managing compliance, and coordinating with clients, often requiring specialized knowledge and certifications. In contrast, the Medicare Customer Service Representative primarily handles inquiries, provides information, and assists beneficiaries directly. Both roles are essential in the Medicare industry but differ in responsibilities, required credentials, and work environment.

More about Medicare Enrollment Manager jobs

What cities are hiring for Medicare Enrollment Manager jobs?

Cities with the most Medicare Enrollment Manager job openings:

What are the most commonly searched types of Medicare Enrollment jobs?

The most popular types of Medicare Enrollment jobs are:

What states have the most Medicare Enrollment Manager jobs?

States with the most job openings for Medicare Enrollment Manager jobs include:

What job categories do people searching Medicare Enrollment Manager jobs look for?

The top searched job categories for Medicare Enrollment Manager jobs are:

Medicare Enrollment Manager jobs near you
Infographic showing various Medicare Enrollment Manager job openings in the United States as of August 2026, with employment types broken down into 88% Full Time, 11% Part Time, and 1% Contract. Highlights an 81% Physical, 2% Hybrid, and 17% Remote job distribution, with an average salary of $86,379 per year, or $41.5 per hour.

Manager, Government Programs (Enrollment)

Capital Rx

Charlotte, NC • On-site

$146K - $182K/yr

Other

Medical

Posted 3 days ago

New

Job description

About Judi Health

Judi Health is a health technology company providing benefit administration solutions to employers, unions, health plans, and government entities. Judi Health replaces fragmented, outdated systems with the industry's first Unified Claims Processing architecture, seamlessly consolidating pharmacy and medical benefit administration on a single, secure platform. By delivering true price transparency, eliminating unnecessary middleman fees, and leveraging advanced AI-powered care delivery, Judi Health helps clients achieve unprecedented operational efficiency and service levels.
At Judi Health, we're deploying the infrastructure our country needs to deliver the healthcare we all deserve. We are the intelligence platform powering benefits plans for millions of Americans and proudly leading the next generation of care. To learn more, visit www.judi.health.

Location: Hybrid (Local to NYC, Denver, CO or Charlotte, NC)

Position Summary:

The Government Programs Enrollment Manager is responsible for the implementation, overall management, oversight and continuous improvement of Medicare enrollment and eligibility operations for the Health Plan EGWP line of business. The role will be responsible for daily management and ongoing oversight of highly vulnerable activities with the Medicare part D Prescription Drug Plan (PDP) Employer Group Waiver Plan (EGWP). This position ensures timely, accurate and compliant processing of Medicare enrollment transactions while maintaining adherence to CMS regulations, contractual requirements and organizational service standards.

Position Responsibilities:

  • Manage enrollment system build and program setup, implementation and go-live readiness, including developing business requirments, workflows, conducting testing and go-live activities.
  • Provides leadership coaching and performance management to Government Programs Enrollment staff to achieve departmental and organizational objectives.
  • Manage day to day Medicare enrollment and eligibility operations including premium billing.
  • Oversee processing of all Medicare enrollment and disenrollment transactions.
  • Ensure compliance with CMS enrollment regulations and service level agreements.
  • Manage issue resolution and corrective action completion.
  • Perform outreach as necessary on missing enrollment information, client file errors and CMS processing errors.
  • Manage monthly data validation audits performed by CMS contractors and respond timely and accurately.
  • Lead regulatory reporting to ensure timely and accurate reporting from both internal and external resources as required by the Health plan, the State and CMS.
  • Collaborate cross functionally across the Judi Health organization on employer group issues, communications and required oversight of enrollment related activities performed by employer groups.
  • Support internal and external audits by federal and state agencies, including audit preparation, documentation, issue response and remediation tracking.
  • Develop compliant documentation for operational areas to include policies, procedures, workflows and other work instructions.

Required Qualifications:

  • Minimum of HS diploma/GED or equivalent experience
  • 5+ years of Medicare Enrollment operations experience
  • Deep knowledge of Medicare enrollment regulations and CMS processing guidelines.
  • Experience working within CMS systems, including but not limited to HPMS and MARx.
  • Experience working in a delegated and highly matrixed organization.

Preferred Qualifications

  • Health Plan Medicare Part D and/or EGWPs
  • Experience with CMS, CMS Contractor and State Audits
  • Strong analytical acumen
New York, NY Salary Range
$146,000—$182,500 USD
Denver, CO Salary Range
$133,600—$167,000 USD
Charlotte, NC Salary Range
$121,600—$152,000 USD

All employees are responsible for adherence to the Judi Health Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found athttps://www.judi.health/legal/privacy-policy.

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