Director, Enrollment (Duals) - REMOTE

Lensa; Cincinnati (OH); Remote; USD 97,000 - 190,000; Full time

Job summary

A leading healthcare provider is seeking a Director for enrollment management. This role involves overseeing member enrollment processes, ensuring compliance, and maintaining accurate records. Ideal candidates will have extensive experience in Medicare and Medicaid regulations. Competitive salary and benefits are offered.

Benefits

Competitive benefits and compensation package

Qualifications

• 7-9 years of Duals / Medicare enrollment experience.
• 10+ years of Medicaid and Medicare Regulations preferred.

Responsibilities

• Preparation, processing, and maintenance of member enrollment records.
• Addresses enrollment questions and maintains records in the database.
• Oversight of enrollment and premium staff.

Skills

Compliance Monitoring

Data Accuracy

Coaching

Subject Matter Expertise

Education

Graduate Degree

Job description

Lensa is the leading career site for job seekers at every stage of their career. Our client, Molina Healthcare, is seeking professionals. Apply via Lensa today!

Job Description

Job Summary

Responsible for the preparation, processing, and maintenance of new members and re-enrollment. Processes and maintains health plan's member and enrollment records, employer's monthly reports, and sends membership cards and materials. Verifies enrollment status, makes changes to records, researches, and resolves enrollment system rejections. Addresses a variety of enrollment questions or concerns received via claims, call tracking, or email. Maintains records in the enrollment database.

Knowledge/Skills/Abilities

• Holds general oversight of enrollment and premium staff at each plan site within a defined region, including employee reviews, coaching sessions, and disciplinary actions.
• Monitors and enforces compliance with company-wide reconciliation processes.
• Ensures accurate delivery of enrollment and premium-related data for the defined region.
• Serves as a subject matter expert for projects and/or new business related to areas of oversight.
• Oversees maintenance of policies and standard operating procedures.

Job Qualifications

Required Education

Graduate Degree or equivalent combination of education and experience.

Required Experience

7-9 years of Duals / Medicare enrollment experience.

Preferred Experience

10+ years, Medicaid, Medicare Regulations.

Additional Information

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $97,299 - $189,782 / ANNUAL

• Actual compensation may vary based on location, experience, education, and skill level.

Additional Details

• Seniority level: Director
• Employment type: Full-time
• Job function: Education and Training
• Industries: IT Services and IT Consulting