Business Analyst

Detroit, Michigan

 w3r Consulting
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Top 3 Required Skills/Experience -
  • CMS Knowledge
  • Data Reconciliation and file management
  • Good Communication
Required Skills/Experience - The rest of the required skills/experience. Include:
Medicare Advantage Enrollment Expertise:
  • Minimum 2-4 years of direct experience with Medicare Advantage Enrollment processes
  • Experience with CMS MAPD, MA and PDP standalone enrollment/disenrollment regulations, enrollment mechanisms, Late Enrollment Penalty (LEP) and Low-Income Subsidy (LIS), Plan Communication User Guide
Data Reconciliation and File Management:
  • Experience with monthly/weekly membership reconciliation
  • Experience with monthly CMS membership reconciliation (MARx, TRR).
  • Ability to analyze discrepancies, manage large datasets and track resolution through internal reporting tools.
  • Knowledge of CMS thresholds and compliance timelines for discrepancy resolution.
  • Understanding of required documentation and timelines for retroactive processing and case development.
Operational Process Improvement:
  • Ability to identify operational gaps, define root causes, and implement process improvements
Regulatory Compliance and Audit Support:
  • Experience supporting internal and CMS program audits and Compliance reporting.
Technical and Reporting Skills:
  • Intermediate experience of Microsoft Programs with Excel (Pivot tables), Word, Outlook, OneNote
Communication and Knowledge Dissemination:
  • Effective written and verbal communication skills
Date Posted: 18 May 2025
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