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Director of Enrollment

Irving, TX, USA | Leading Non-Profit / Social Enterprise Company

  • Industry:
    Non-Profit / Social Enterprise
  • Position Type:
  • Functions:
    Business Development
  • Experience:
    10-12 years
Job Description:
51 people have viewed this job

Manages multiple teams responsible for preparing, processing and maintaining new member or group enrollments, and overseeing the loading of new members or group data into appropriate eligibility systems.

Collaborates with other service function leaders to prioritize emerging issues and coordinate timely resolutions, including Call Center Operations and Complaints & Appeals.

Has oversight for ongoing data reconciliation activities, with both government entities and employers; will lead teams in analyzing transactional data, prioritizing discrepancies and providing timely and accurate resolution.

Establishes and executes a detailed renewal plan for all lines of business, focusing on member retention and member satisfaction.

Primary liaison to external vendors supporting enrollment and/or billing, with oversight to both day-to-day functions and ad hoc needs.

Oversees the documentation of business requirements to enhance or expand operational efficiencies supporting enrollment and billing; provides input to cross-functional prioritization meetings, to establish both tactical and strategic improvements.

Manages staff in daily functions to ensure all processes are completed within regulatory and quality standards

Meets and exceeds department quality audits and provide coaching to team members

Oversees internal enrollment agents, trains and supervises agents on the enrollment process

Handle all escalations courteously, politely and professionally

Act as back-up support for departmental managers and leadership as needed for meetings and other departmental responsibilities

Serves as the subject matter expert for the enrollment process for multiple plans, including Medicare Advantage, Small Group, Uniformed Services Family Health Plan, and Health Insurance Exchange.

Acts as the liaison with federal and state contacts on eligibility and enrollment topics

Supports external audits focused on enrollment and/or billing data and functions, as needed.

Perform other duties as assigned


Requirements


College degree and/or minimum of 10 years of healthcare supervisory experience.

Strong knowledge and experience with Medicare policies and standards of eligibility.

Strong knowledge and experience with Individual and Small Group enrollment, rating and billing regulations, post-ACA.

Must have strong analytical, and writing skills


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