Medicare Sales Analyst

Immediate need for a talented Medicare Sales Analyst. This is a 03 Months Contract opportunity with long-term potential and is located in Philadelphia, PA  (Hybrid). Please review the job description below and contact me ASAP if you are interested.

Job ID:26-05215

Pay Range: $35 - $40/hour.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
 
Key Responsibilities:

• Monitor the Sales Allegation mailbox for investigation requests related to Medicare Advantage sales agents. Requests are primarily submitted by the Medicare Appeals & Grievances team and the CTM team but may come from any internal department.
• Track all incoming investigation requests using the established sales allegation tracker.
• Contact members by phone or by mail to obtain more details regarding their complaint.
• Contact sales agents via email to gather information about the complaint.
• Collaborate with internal partners such as Sales, Appeals & Grievances, Enrollment, Claims, Pharmacy, and Product Management as needed throughout the investigation.
• Document all investigative findings in a Word report for management review before closing the case.
• Save all investigation-related documentation in the designated shared drive.

Key Requirements and Technology Experience:

• Knowledge of appeals and grievances is preferred but not required.
• Understanding of CMS requirements related to Medicare sales and agents is preferred but not required.
• Familiarity with Medicare Compliance is beneficial but not required.
• The ideal candidate is detail-oriented, comfortable communicating with both members and internal stakeholders, and skilled at organizing and documenting information.
• A background in Medicare operations, grievances, appeals, or compliance is highly valuable.
• Microsoft Office tools knowledge
• Excellent organizational, verbal, and written communication skills required.
• CMS requirement experience is a plus
• BS or equivalent work experience
• Minimum of 3 years related work experience in managed care or health care.

Our client is a leading Health Insurance Industry and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.
 
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