Director, Enrollment (Duals) - REMOTE

Molina Healthcare; City of Albany (NY); Remote; USD 97,000 - 190,000; Full time

Job summary

An established industry player is seeking a dedicated Enrollment Manager to oversee the preparation and maintenance of member records. This role involves ensuring compliance with enrollment processes, managing staff oversight, and serving as a subject matter expert in Medicare and Medicaid regulations. The ideal candidate will bring extensive experience in enrollment processing and data management, contributing to the success of the organization. Join a forward-thinking company that values its employees and offers a competitive compensation package while making a meaningful impact in the healthcare sector.

Qualifications

• 7-9 years of experience in Duals / Medicare enrollment required.
• Graduate degree or equivalent education and experience.

Responsibilities

• Responsible for processing and maintaining member enrollment records.
• Ensures compliance with company-wide reconciliation processes.

Skills

Enrollment Processing

Compliance Monitoring

Data Management

Staff Oversight

Education

Graduate Degree

Job description

Job Description

Job Summary

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, sending 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 e-mail. 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, including Medicaid and Medicare regulations.

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/or skill level.