Medicare & Medicaid Enrollment Analyst

 

At Curana Health, we're on a mission to radically improve the health, happiness, and dignity of older adults—and we're looking for passionate people to help us do it.

 

As a national leader in value-based care, we offer senior living communities and skilled nursing facilities a wide range of solutions (including on-site primary care services, Accountable Care Organizations, and Medicare Advantage Special Needs Plans) proven to enhance health outcomes, streamline operations, and create new financial opportunities.

 

Founded in 2021, we've grown quickly—now serving 200,000+ seniors in 1,500+ communities across 32 states. Our team includes more than 1,000 clinicians alongside care coordinators, analysts, operators, and professionals from all backgrounds, all working together to deliver high-quality, proactive solutions for senior living operators and those they care for.

 

Ranked #147 on the Inc. 5000 list of America's fastest-growing private companies, we're just getting started. If you're looking to make a meaningful impact on the senior healthcare landscape, you're in the right place—and we look forward to working with you.

 

For more information about our company, visit CuranaHealth.com.

Summary

The Medicare & Medicaid Enrollment Analyst is responsible for overseeing and managing all Medicare and Medicaid enrollment revalidations for both individual providers and provider groups. This role serves as the organization's subject matter expert on government payer enrollment processes, ensuring timely revalidation, maintenance, and compliance with federal and state regulations.

 

The coordinator manages the full revalidations for physicians, nurse practitioners, physician assistants, and organizational entities to ensure uninterrupted billing, reimbursement, and regulatory compliance. The position works collaboratively with Credentialing, Revenue Cycle, Compliance, Billing, and Operations teams to support organizational growth and provider onboarding initiatives.

Essential Duties & Responsibilities

Medicare Provider & Group Enrollment

• Prepare, submit, and monitor individual and group Medicare revalidations through PECOS.
• Manage Medicare revalidations and enrollment maintenance requests.
• Track PTAN assignments, effective dates, and approval statuses.
• Coordinate electronic signatures and supporting documentation required for Medicare revalidations.
• Maintain compliance with CMS regulations and Medicare Administrative Contractor (MAC) requirements.

Medicaid Provider & Group Enrollment

• Submit revalidation Medicaid applications for both individual providers and provider organizations.
• Coordinate state-specific Medicaid enrollment requirements and supporting documentation.
• Monitor application status and resolve deficiencies with state Medicaid agencies.

Enrollment Lifecycle Management

• Develop and maintain tracking systems for all Medicare and Medicaid revalidation activities.
• Monitor revalidation due dates, enrollment expirations, and regulatory deadlines.
• Conduct routine follow-up with Medicare contractors and state Medicaid agencies.
• Ensure all enrollment milestones are documented and reported accurately.
• Escalate delayed or high-risk applications to leadership as appropriate.

Compliance & Regulatory Oversight

• Ensure all activities comply with CMS, Medicare, Medicaid, and organizational requirements.
• Maintain complete and audit-ready enrollment files and supporting documentation.
• Assist with internal audits, accreditation reviews, and regulatory requests.
• Monitor changes in Medicare and Medicaid enrollment policies and communicate impacts to stakeholders.
• Implement process improvements to enhance enrollment efficiency and accuracy. 

Cross-Functional Collaboration

• Serve as the primary resource for Medicare and Medicaid revalidation guidance.
• Collaborate with Billing, Revenue Cycle, Credentialing, Compliance, and Operations teams.
• Research and resolve enrollment-related billing delays, claim denials, and reimbursement issues.
• Provide status updates and reporting to leadership and operational stakeholders.

Qualifications

Qualifications

Required

• High School Diploma or equivalent required.
• Minimum of three years of Medicare and Medicaid experience.
• Experience managing both provider and organizational/group enrollments.
• Strong knowledge of CMS enrollment regulations, PECOS, Medicare revalidation requirements, and state Medicaid enrollment processes.
• Experience working with enrollment tracking systems and provider management platforms.
• Strong organizational, analytical, and problem-solving skills.

Preferred

• Multi-state Medicare and Medicaid experience.
• Experience with CredentialStream, CAQH, and provider enrollment software platforms.
• Experience supporting physician groups, skilled nursing facility practices, long-term care organizations, or multi-state healthcare organizations. 

Core Competencies

• Medicare Expertise
• Medicaid Expertise
• Group & Organizational Enrollment Management
• Regulatory Compliance
• CMS & State Agency Relations
• Revenue Cycle Awareness
• Process Improvement
• Critical Thinking
• Project Management
• Data Tracking & Reporting
• Provider Relations
• Cross-Functional Collaboration