Medicare Advantage and DSNP Enrollment Analyst

Mass General Brigham Health Plan
United States, Massachusetts, Somerville
399 Revolution Drive (Show on map)
Aug 06, 2025
This position is responsible for monitoring and optimizing processes related to Medicare Advantage and D-SNP Enrollment. Duties and Responsibilities: -Monitor and analyze Medicare Advantage and D-SNP Enrollment operations to ensure timeliness, accuracy and compliance internally. Collaborate with vendor partners to monitor and analyze enrollment reporting. -Review, track, and communicate key performance indicators (KPIs) related to compliance, timeliness, and accuracy. -Work closely with internal departments, including but not limited to Sales, Finance, Customer Service, Claims, IT, Product, Marketing, STARS leadership, and Digital Services to ensure seamless coordination and integration of enrollment operations. -Identify operational inefficiencies or process bottlenecks and recommend improvements to enhance workflows, reduce costs, and improve member satisfaction. -Assist with the implementation and management of new health plan products or changes to existing plans. -Support the creation and maintenance of health plan policies, procedures, and workflows to ensure compliance with CMS and EOHHS regulatory requirements. -Provide audit support, both internal and external, and support the monthly Enrollment Data Validation (EDV) and Residence Address Change (RAC) processes for all contracts. -Create and update Enrollment and Premium Billing reports. Identify trends, recommend actions, and escalate to leaders as appropriate. -Performs other duties as assigned -Complies with all policies and standards Qualifications Bachelor's Degree required; experience can be substituted for years of experience At least 2-3 years of health Insurance or Healthcare Industry experience required Medicare experience preferred. Massachusetts Medicaid experience preferred. Working Conditions This is a remote role that can be done from most US states Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.