M3P Elections and Enrollment - Sr Business Analyst - Remote

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities.

Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

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* * If candidate resides within 30 minutes of Eden Prairie, MN or Washington, DC, the role will be hyrbid and required to work in the office 4 days per week * *
* 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.

Primary Responsibilities:

* Election Issue Management & Resolution

* 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 , 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

* Election Processing & Data Validation

* 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

* Client Coordination & Communication

* 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…