Sales Solutions Analyst

Position: Sales Solution Analyst

Location: Remote (United States)

Employment Type: Full-Time Contract

Schedule: Monday-Friday (8 AM - 5 PM)

Pay: $27.14 per hour 

Description: Investigate all sales related complaints for agents and agencies including internal and external and report the findings back to the responsible area which could be internally or to CMS.

Responsibilities:

• Investigate and resolve complex sales-related complaints (MAPD, PDP, CSB, CTMs, CSVs, and escalated inquiries) while ensuring compliance with CMS, state, and federal regulations.
• Manage assigned caseloads, conduct thorough research, document findings, communicate resolutions, and ensure timely case completion within internal and CMS deadlines.
• Analyze complaint trends, identify root causes, recommend corrective actions, and implement proactive measures to prevent future issues.
• Make outbound calls, draft written correspondence, and collaborate with internal departments and external partners to resolve member and customer concerns.
• Manage, process, document, and present Sales Development Action Program (SDAP) cases and committee findings.
• Support ongoing oversight activities for SDAP and Complaint Investigation processes, including complaint tracking, reporting, CRM updates, and sales support functions.
• Serve as a subject matter expert for complaint investigations and compliance-related issues for Sales, Operations, Account Management, Escalations, Broker Strategists, and other stakeholders.
• Provide technical guidance on regulatory requirements, program development, maintenance activities, compliance reporting, and process improvements.
• Perform quality reviews, audits, data requests, reporting, document maintenance, and special projects to ensure compliance with CMS and HealthSpring policies and procedures.
• Train and mentor new Lead Analysts on departmental processes, workflows, and best practices. 
• Independently resolve complex customer, agent, and partner issues using sound judgment, discretion, and negotiation skills.
• Maintain professional knowledge of Medicare Communication and Marketing Guidelines and other applicable regulatory requirements.
• Demonstrate professionalism, integrity, and respect in all interactions while supporting 24/7 operational needs, including weekends, as required.
• Perform additional duties and responsibilities as assigned by Sales Integrity Leadership.

Requirements:

• High School Diploma required
• BA/BS or equivalent work experience –6+ years of experience in Medicare Advantage
• 5+ years of experience in regulatory/compliance, MAPD Sales, or other relevant work experience preferred
• Knowledge of CMS and HealthSpring compliance policies and procedures
• High attention to detail, quality and accuracy
• Strong coordination and organizational skills
• Excellent verbal and written communication skills, as well as, listening and conflict resolution skills.
• Ability to exercise administrative judgment and assumes responsibility for decisions, consequences, and results that have an impact on people, costs, and/or quality of service within the functional area.
• Basic understanding of managed care and its place in the health care industry.
• Ability to identify and analyze problems and recommend solutions.
• Proficiency with analytical tools, knowledge of data analysis methodology, strong communication skills and strong commitment to and affinity for delivering the highest level of customer service.
• Sales and/or training experience recommended
• Ability to handle multiple assignments, projects and deliverables simultaneously 
• Ability to work under pressure and flexible hours required; weekend on call hours as needed

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