Senior Associate Membership Operations

Posted 8 days ago

virtual vocationsNew York (NY)

Medical Records Specialists Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

SENIORITY

Senior

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About the role

Researching and addressing complex retroactive transaction issues, the full-time Senior Associate Membership Operations will manage escalated cases, develop repeatable processes, and coordinate remediation efforts, all while working remotely.

Key responsibilities: Research and resolve escalated retroactive transaction issues using CMS guidance and established procedures Assist in the development of tools and playbooks to streamline operational processes Coordinate downstream remediation efforts to ensure member corrections are effectively managed Required qualifications 3-5 years of experience in healthcare, with knowledge of Medicare or Medicaid requirements Proficiency with data tools, including spreadsheets; SQL experience is a strong plus Experience in writing business requirements or collaborating with technical teams on operational tools Ability to thrive in a fast-paced, startup environment Compassion for the healthcare challenges faced by the Medicare population

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