Job Description

• The resource will work three days a week at the client location until fully trained, and thereafter, depending on their progression, they will then work once a week onsite.
• The Business Analyst Sr. is responsible for leading and/or supporting processes that ensure oversight and ongoing monitoring of Client's Medicare Advantage and Part D programs.
• The primary duties of this role encompasses overseeing sales and enrollment processes to ensure compliance with Client regulations for Medicare Advantage operations.
• Additionally, the position involves enhancing workflows and business processes to bolster controls, mitigate risk, and enhance overall quality and efficiency.

• Compliance Monitoring: Ensure agents comply with Client regulations and guidelines for selling and enrolling Medicare Advantage plans.
• Quality Assurance: Monitor and evaluate agent performance to ensure quality service and accurate information to potential beneficiaries.
• Policy Interpretation: Interpret and communicate Medicare policies and guidelines.
• Metric Tracking: Establish and track performance metrics to assess agent effectiveness and identify areas for improvement.
• Regulatory Updates: Stay informed about changes in Medicare policies and regulations to ensure agents remain compliant.
• Collaboration and Communication: Collaborate with cross-functional teams and communicate with stakeholders to ensure alignment and effectiveness in oversight.
• Process Improvement: Continuously identify and implement process improvements to enhance efficiency and effectiveness in oversight.
• Legal and Ethical Adherence: Ensure that agencies and agents adhere to legal and ethical standards in their interactions with beneficiaries.
• Risk Management: Identify and mitigate risks associated with agent activities to maintain compliance and protect the organization's reputation.

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