Manager, Medicare Enrollment and Reconciliation

Tasks

• Apply audit findings for process improvements
• Attend CMS training
• Collaborate to resolve enrollment data issues
• Ensure audit compliance
• Establish enrollment and reconciliation department priorities
• Identify document and report discrepancies
• Interpret Medicare Advantage enrollment rules
• Lead data analytics projects
• Maintain enrollment file integrity
• Maintain regulatory knowledge
• Mentor train and develop staff
• Oversee CMS MARx enrollment processing
• Perform enrollment and payment reconciliation governance
• Reconcile CMS response files
• Resolve enrollment rejections
• Support brokers and IPA PCP eligibility workflows

Perks/Benefits

• N/A

Skills/Tech-stack

Audit compliance | CMS MARx | CMS eligibility policy | CMS response files | Eligibility Policy | Enrollment Reconciliation | HPMS memos | Low Income Subsidy | Medicare Advantage | Medicare Enrollment | Payment Reconciliation | Plan Communications User Guide | Retroactive adjustments | User Guide