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Medicare Enrollment Manager Jobs in Riverside, CA

Partners in Diversity

Program Assistant

Orange, CA

$23.92 - $33.48/hr

The Program Assistant (Enrollment Medicare) will assist with the specialized services for Medicare ... The incumbent will prioritize daily tasks and work items in queue, manage turnaround times and ...

Astiva Health

Member Services Representative

Orange, CA · On-site

$24 - $29/hr

... regarding Medicare Advantage benefits, eligibility, enrollment, claims, referral, prior ... Ability to multi-tasks, time manage and prioritize. * Ability to document information while on the ...

Alignment Healthcare

VP, Internal Audit

Orange, CA · On-site

... management, and regulatory oversight across all business operations. This leader works in close ... to Medicare Advantage-enrolled seniors. Job Profile Summary The VP, Internal Audit is a highly ...

Alignment Healthcare

VP, Internal Audit

Orange, CA

... management, and regulatory oversight across all business operations. This leader works in close ... to Medicare Advantage-enrolled seniors. Job Profile Summary The VP, Internal Audit is a highly ...

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All JobsMedicare Enrollment JobsMedicare Enrollment Manager JobsMedicare Enrollment Manager Jobs in Riverside, CA

Medicare Enrollment Manager information

See Riverside, CA salary details

$37K

$90.1K

$122.1K

How much do medicare enrollment manager jobs pay per year?

As of Aug 6, 2026, the average yearly pay for medicare enrollment manager in Riverside, CA is $90,116.00, according to ZipRecruiter salary data. Most workers in this role earn between $62,600.00 and $121,500.00 per year, depending on experience, location, and employer.

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.

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 job categories do people searching Medicare Enrollment Manager jobs in Riverside, CA look for? The top searched job categories for Medicare Enrollment Manager jobs in Riverside, CA are:
What cities near Riverside, CA are hiring for Medicare Enrollment Manager jobs? Cities near Riverside, CA with the most Medicare Enrollment Manager job openings:
Medicare Enrollment Manager jobs near you
Infographic showing various Medicare Enrollment Manager job openings in Riverside, CA as of August 2026, with employment types broken down into 100% Full Time. Highlights an 75% In-person, 8% Hybrid, and 17% Remote job distribution, with an average salary of $90,116 per year, or $43.3 per hour.

Payer Contract Specialist

Charter Healthcare

Rancho Cucamonga, CA • On-site

$24.01 - $35/hr

Full-time

Re-posted 16 days ago

Job description

POSITION SUMMARY: The Payor Contract Specialist: Responsible for managing the day-to-day responsibilities related to managed care contracting and payer/provider relations. This includes acting as the liaison between agencies and contracted health plans to disseminate information, research reimbursement and clinical policies, support provider credentialing and onboarding, and resolving claims and other payer issues.
REPORTS TO: Compliance Contract Manager
SUPERVISES: None
QUALIFICATIONS:
Education: Bachelorâ€'s degree is required. Masterâ€'s or Juris Doctorate degree is preferred.
Experience: A minimum of 5 years’ experience in a healthcare organization, to include demonstrated leadership in payor contracting. Familiarity with operational, financial, quality assurance, and human resource procedures and regulations is a must.
Core Competencies: Knowledge and understanding of healthcare industry, legal and regulatory requirements. Exceptional and proven provider skills and interpersonal skills. Excellent contract negotiation skills. Results driven and able to self-direct. Strong organizational and analytical skills. Well-developed communication skills. Demonstrated strength in computer software, e.g., Excel, Microsoft Word, PowerPoint, etc.
Other: Valid driverâ€'s license and auto insurance.
FUNCTIONS AND RESPONSIBILITIES:
1. Develop, negotiate, and maintain contracts with all payers, e.g., insurance companies, , MSOs, IPAs, TPAs, and government programs. This includes researching territories to identify gaps with our payer base and supporting the expansion into new markets.
2. Assure contractual arrangements meet financial targets and legal/regulatory compliance requirements. There will be an emphasis on analyzing cost and utilization data.
3. Facilitate the approval process of all contract documents from pre-contract through post-signature phases.
4. Responsible for the accuracy of supporting documentation for contracts and completing documents accurately.
5. Maintain existing relationships with contracted providers. Ensure contractual language is kept current; evaluate fee schedule on a yearly basis to identify possible opportunities for additional covered services, medical policy changes and reimbursement.
6. Complete Medicare enrollment for new entities and markets. Coordinate with internal teams as necessary to support Medicare assignments.
7. Track and report contract renewal dates and alert management 90 days prior to renewal dates.
8. Track contract status and ensure contracts transition to the next stage in the life cycle timely.
9. Monitor for rate renewal, increases, and changes to ensure we realize the intended negotiated contracted rate.
10. Meets routinely with system and health plans to resolve contracting/claims issues.
11. Supports contract negotiation efforts by revenue modeling and rate evaluation.
12. Coordinate and communicate contractual terms to the billing department; ensure staff is informed of changes in medical policy and binning policies.
13. Assure accurate data entry of contract specifications and terms into database and completeness of all contracting processes.
14. Serve as a point of contact on health plan architecture, network restrictions, product offerings and other components of the health plan marketplace.
15. Maintain excellent written and verbal communication with all internal and external customers.
16. Assist with all contracting administration and projects, as needed.
17. All other duties and responsibilities as assigned.

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