M3P Elections and Enrollment - Sr Business Analyst - Remote

UnitedHealth Group•Eden Prairie, MN

3h•$72,800 - $130,000•Remote

About The Position

The Sr. Business Analyst (M3P Elections & Enrollment) will support the Medicare Prescription Payment Plan (M3P) Election Management function within pharmacy benefit management (PBM) operations. As part of this team, you will play a critical role in ensuring the accuracy and integrity of member elections (opt-ins, opt-outs, renewals, and involuntary terminations) across multiple clients and systems, including enrollment management platforms, claims adjudication systems, and billing engines. You will be responsible for election issue investigation and resolution, client-facing coordination, process documentation, and data validation - contributing directly to CMS compliance, member experience, and operational excellence. We are a key support team focused on the accuracy of member enrollment, election processing, and communications - taking care to identify areas of risk and closing gaps where members may be negatively impacted. Strategically, we are poised to proactively develop and maintain policies and procedures that deliver consistently superior performance, encourage objective measurement and results, and support an environment of continual improvement. The ideal candidate is able to recognize problems and opportunities, apply a repeatable approach to solutioning, and deliver consistent value. You’ll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges. For all hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Requirements

3+ years of experience in business analysis, enrollment/eligibility operations, or healthcare operations
Experience evaluating business processes, identifying gaps, and driving process improvement
Proficiency with IT service management (ITSM) or ticketing platforms (eg, ServiceNow, Jira, Remedy)
Proven solid analytical skills with the ability to research and resolve complex member-level data discrepancies across multiple systems
Proven excellent written and verbal communication skills, including the ability to draft polished client-facing communications and SOPs
Demonstrated ability to manage multiple priorities and meet deadlines in a fast-paced environment

Nice To Haves

Experience with Medicare Part D programs, CMS regulations, and M3P or similar election/enrollment programs
Experience working wtih RXclaim
Experience building or contributing to dashboards in Power BI, Tableau, or similar business intelligence tools
Experience with cross-functional coordination across IT, compliance, account management, and client-facing teams
Familiarity with pharmacy benefit management (PBM) systems and election processing workflows (API, batch file, paper/mail, phone, web portal)
Knowledge of CMS audit requirements, MARx reporting, PDE submissions, and HPMS processes

Responsibilities

Manage and resolve M3P election-related tickets and service requests (incidents, inquiries, provisioning requests), ensuring documentation, tracking, and resolution within established SLAs
Investigate and resolve election discrepancies across systems, including Medicare Beneficiary Identifier (MBI) mismatches, group/plan ID misalignments, enrollment sync issues, and retroactive election corrections
Coordinate with IT and cross-functional partners to identify root causes and drive remediation for systemic election processing errors (eg, opt-out/opt-in timing issues, duplicate member profiles, eligibility sync failures)
Support CMS MARx transaction and PDE gap file analysis, as well as HPMS report validations related to elections and enrollment
Process and validate API and batch election file loads for multiple health plan clients, including reviewing load reports for errors, rejections, and trends
Monitor and manage the election request queue within the enrollment management platform, addressing records with statuses such as missing signature, missing information, and eligibility mismatches
Perform member eligibility research using enrollment, claims, and billing systems to verify election records, plan assignments, and enrollment timelines
Support regression testing and production validation for system releases, including pre-, during-, and post-deployment testing activities
Serve as a key point of contact for client-facing election and enrollment inquiries, including recurring status meetings with health plan partners
Collaborate with account management and client teams to resolve batch file errors, onboard new clients to API/batch election processes, and ensure client readiness during the Annual Enrollment Period (AEP)
Identify coaching opportunities for call center representatives and downstream teams to reinforce correct election methods and CMS compliance
Create, update, and maintain standard operating procedures (SOPs) and job aids for key election processes, including batch processing, mail-in election submissions, election queue monitoring, error report review, and CMS audit documentation
Contribute to key controls initiatives by establishing end-to-end visibility into all election and enrollment data streams, documenting how data is received, stored, and validated, and establishing quality assurance (QA) controls
Support cross-training initiatives to enable enrollment and eligibility team members to independently resolve issue management tickets across functional areas
Prepare and deliver operational reports (eg, monthly business review reports) with metrics on ticket volumes, turnaround times, error categories, and election request trends
Support the development and maintenance of dashboards to track election volume, error rates, SLA compliance, and client performance scorecards
Leverage project management and workflow tracking tools for workload management, project tracking, and operational reporting