Senior Analyst - Health Insurance Operations

Health Operations Senior Analyst

Skill required: Membership - Life Sciences Regulatory Operations
Designation: Health Operations Senior Analyst
Qualifications:BBA/BCom/BMS
Years of Experience:5 to 8 years
Language - Ability:English(Domestic) - Proficient
About Accenture
Accenture is a global professional services company with leading capabilities in digital, cloud and security.Combining unmatched experience and specialized skills across more than 40 industries, we offer Strategy and Consulting, Technology and Operations services, and Accenture Song— all powered by the world’s largest network of Advanced Technology and Intelligent Operations centers. Our 784,000 people deliver on the promise of technology and human ingenuity every day, serving clients in more than 120 countries. We embrace the power of change to create value and shared success for our clients, people, shareholders, partners and communities.Visit us at www.accenture.com
What would you do? The Team Lead – Medicare Enrollment is responsible for overseeing the daily operations of the enrollment team, ensuring accurate and timely processing of Medicare applications, renewals, and disenrollments. This role ensures compliance with regulatory guidelines (such as those from the Centers for Medicare & Medicaid Services (CMS)) and internal policies while driving team productivity, quality, and continuous improvement. Team Leadership & Management: Lead, mentor, and support a team of enrollment processors Assign workloads and monitor productivity and turnaround times (TAT) Conduct team meetings, one-on-ones, and performance evaluations Provide training, coaching, and development support to team members Enrollment Operations Oversight: Oversee processing of Medicare enrollment, re-enrollment, and disenrollment applications Ensure accuracy and completeness of member records Monitor daily queues and prioritize workloads to meet SLAs Handle complex cases and provide guidance on escalations Compliance & Quality Assurance: Ensure adherence to CMS guidelines and regulatory requirements Maintain compliance with Health Insurance Portability and Accountability Act (HIPAA) standards for data confidentiality Conduct quality audits and provide feedback for performance improvement Identify and mitigate compliance risks Stakeholder Coordination: Collaborate with cross-functional teams (claims, billing, customer service, providers) Act as the point of contact for escalations from members, providers, and internal stakeholders Ensure clear communication of enrollment updates and issues Reporting & Process Improvement: Track and analyze team performance metrics (productivity, accuracy, TAT) Prepare reports and dashboards for management review Identify process gaps and implement improvements to enhance efficiency Support system updates, policy changes, and process transitions
What are we looking for? •Health Insurance Operations Strong leadership and team management skills In-depth knowledge of Medicare enrollment processes Understanding of CMS regulations and compliance standards Excellent communication and interpersonal skills Analytical thinking and problem-solving ability Strong organizational and time management skills
Roles and Responsibilities: •In this role you are required to do analysis and solving of increasingly complex problems • Your day to day interactions are with peers within Accenture • You are likely to have some interaction with clients and/or Accenture management • You will be given minimal instruction on daily work/tasks and a moderate level of instruction on new assignments • Decisions that are made by you impact your own work and may impact the work of others • In this role you would be an individual contributor and/or oversee a small work effort and/or team • Please note that this role may require you to work in rotational shifts