Director, Enrollment (Duals) - REMOTE

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

Job summary

An established industry player is seeking a Director of Enrollment to lead a dedicated team responsible for managing health plan enrollment processes. This role requires extensive experience in Medicare and Medicaid regulations, ensuring compliance and accuracy in data management. The ideal candidate will oversee staff, provide coaching, and serve as a subject matter expert for enrollment-related projects. Join a forward-thinking organization that values your expertise and offers a competitive compensation package, making a significant impact in the healthcare sector.

Qualifications

• 7-9 years of experience in Duals / Medicare enrollment.
• 10+ years preferred, including Medicaid and Medicare regulations.

Responsibilities

• Oversee preparation and maintenance of member enrollment records.
• Address enrollment questions and maintain database records.

Skills

Enrollment Processing

Compliance Monitoring

Data Accuracy Management

Coaching and Employee Reviews

Subject Matter Expertise

Education

Graduate Degree

Job description

Job Description

Responsible for 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 that delivery of enrollment/premium related data is accurate 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, including Medicaid and 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 geographic location, work 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

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