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Medicare Operations Analyst Jobs (NOW HIRING)

Conflux Systems

Medicare Domain SME

Medicare operations workflow This Expert must be able to play a leadership role in managing and coordinating the members of the BIA team. They must have excellent interpersonal skills, be self ...

Bcbsa

Responsible for overseeing day-to-day operational work streams that support Medicare products and ... Strong analytical skills with ability to interpret utilization data, competitive benchmarking, and ...

Bcbsa

Responsible for overseeing day-to-day operational work streams that support Medicare products and ... Strong analytical skills with ability to interpret utilization data, competitive benchmarking, and ...

Bcbsa

Medicare Operations Senior Program Manager

OR · On-site +1

Responsible for overseeing day-to-day operational work streams that support Medicare products and ... Strong analytical skills with ability to interpret utilization data, competitive benchmarking, and ...

Bcbsa

Responsible for overseeing day-to-day operational work streams that support Medicare products and ... Strong analytical skills with ability to interpret utilization data, competitive benchmarking, and ...

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Medicare Operations Analyst information

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How much do medicare operations analyst jobs pay per hour?

As of Sep 10, 2026, the average hourly pay for medicare operations analyst in the United States is $33.75, according to ZipRecruiter salary data. Most workers in this role earn between $24.04 and $40.38 per hour, depending on experience, location, and employer.

What is a Medicare Operations Analyst?

Medicare Operations Analysts are professionals who oversee and enhance the operational processes associated with Medicare insurance programs. They analyze data, monitor regulatory compliance, and identify areas for process improvement within healthcare organizations or insurance companies. Their responsibilities often include preparing reports, ensuring claims are processed accurately, and implementing new policies or procedures to align with Medicare regulations. By streamlining workflows and maintaining compliance, they help organizations deliver efficient and effective services to Medicare beneficiaries.

What are some common challenges faced by a Medicare Operations Analyst in ensuring compliance with regulatory requirements?

Medicare Operations Analysts often face the challenge of staying up-to-date with frequently changing regulations and policies from CMS (Centers for Medicare & Medicaid Services). This requires continuous monitoring and interpretation of new guidelines to ensure that all operational processes remain compliant. Additionally, analysts must communicate changes effectively to cross-functional teams and help implement process adjustments without disrupting service quality. Strong analytical skills and attention to detail are essential to address these challenges and maintain compliance in a fast-paced environment.

What are the key skills and qualifications needed to thrive as a Medicare Operations Analyst, and why are they important?

To thrive as a Medicare Operations Analyst, you need a strong understanding of Medicare regulations, data analysis, and healthcare operations, often supported by a bachelor's degree in healthcare administration, business, or a related field. Familiarity with data analytics tools (such as Excel, SQL, or Tableau), claims processing systems, and CMS platforms is typically required. Attention to detail, problem-solving abilities, and effective communication are standout soft skills for this role. These skills ensure accurate compliance, efficient workflow optimization, and clear reporting within the complex Medicare environment.

What cities are hiring for Medicare Operations Analyst jobs?

Cities with the most Medicare Operations Analyst job openings:

What states have the most Medicare Operations Analyst jobs?

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

What are popular job titles related to Medicare Operations Analyst jobs?

For Medicare Operations Analyst jobs, the most frequently searched job titles are:

Infographic showing various Medicare Operations Analyst job openings in the United States as of September 2026, with employment types broken down into 1% As Needed, 84% Full Time, 12% Part Time, 1% Temporary, 1% Contract, and 1% Nights. Highlights an 93% Physical, 2% Hybrid, and 5% Remote job distribution, with an average salary of $70,210 per year, or $33.8 per hour.

Medicare Operations Analyst (Temporary)

Washington, DC • On-site

ASSOCIATION FOR COMMUNITY AFFILIATED PLANS
Health Care and Social Assistance • 11 - 50 employees
Learn more about ASSOCIATION FOR COMMUNITY AFFILIATED PLANSexternal

$36 - $48/hr

Other

Posted 9 days ago

Key responsibilities

  • Supports Medicare operations, sales, and enrollment functions through analysis and interpretation of Medicare and Medi-Cal data.

  • Conducts complex research and analysis to support Medicare Operations activities.

  • Acts as a subject matter expert and liaison to internal and external stakeholders.

Job description

What You'll Be Responsible For

Reporting to the Medicare Operations Director, this position:

  • Supports Medicare operations, sales, and enrollment functions through analysis and interpretation of Medicare and Medi-Cal data and ensures compliance with applicable state and federal regulations
  • Conducts complex research and analysis in support of Medicare Operations activities
  • Acts as a subject matter expert and liaison to internal and external stakeholders
What You'll Need to Be Successful
  • Knowledge of CMS guidelines related to Medicare sales and enrollment
  • Medicare Advantage enrollment processes and financial reconciliation
  • Contents and interpretation of monthly membership reports
  • Research, analysis, and reporting methods
  • Data analysis tools, CRM/enrollment systems, and the use of databases
  • Analyze complex data sets and present actionable insights
  • Identify issues, gather and analyze information and data, reach logical and sound conclusions, and make recommendations for action
  • Interpret, explain and apply applicable policies, laws, codes, regulations, and contracts
  • Organize work, manage multiple projects, establish priorities, adjust to changing priorities, and meet deadlines
  • Assist with the development and implementation of projects, systems, programs, policies, and procedures
  • Develop and implement operational workflows
Education and Experience
  • Bachelor’s degree in Business Administration, Health Care Administration, Public Health, or a related field
  • Minimum of five years of progressively responsible experience related to Medicare membership operations and or enrollment eligibility
  • Master’s degree may substitute for two years of the required experience; or an equivalent combination of education and experience may be qualifying
Other Information

We are in a hybrid work environment, and we anticipate that the interview process will take place remotely via Microsoft Teams. While some staff may work full telecommuting schedules, attendance at quarterly company-wide events or department meetings will be expected. In-office or in-community presence may be required for some positions and is dependent on business need. Details about this can be reviewed during the interview process. This is a temporary position and does not provide the benefits that are listed below (this is standard language from our regular job posts and cannot be altered or removed). Temporary employees on assignment at the Alliance will be connected to a staffing agency with separate benefit options.

Compensation Information

Zone 1 Pay Range: $36.00 - $48.00. Typical areas in Zone 1: Santa Cruz, San Benito, and Monterey Counties, Bay Area, Sacramento, Los Angeles and San Diego areas

Zone 2 Pay Range: $34.00 - $45.00. Typical areas in Zone 2: Mariposa and Merced Counties, Fresno area, Bakersfield, Eastern California, San Luis Obispo area, and the Central Valley (except Sacramento)

The applicable salary ranges are based on work location and are aligned to a zone according to the cost of labor in your area. All ranges are subject to change in the future. We are happy to answer any questions that you have or share the applicable pay zone for your location if it’s not one of the typical areas listed. You can reach out to careers@thealliance.health, and a member from our Talent Acquisition team will be in touch. The posted hiring ranges represent a good-faith estimate of what a temporary employee would be paid on this assignment. Final compensation will be determined by our compensation philosophy, analysis of the selected candidate’s qualifications (direct or transferable experience related to the position, education, or training), as well as other factors (internal equity, market factors, and geographic location).

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