Director, Enrollment (Duals) - REMOTE

Lensa; Houston (TX); Remote; USD 97,000 - 190,000; Full time

Job summary

A leading healthcare company seeks a Director for enrollment management. This role involves overseeing enrollment processes, ensuring compliance, and maintaining accurate records for Medicare and Medicaid programs. The ideal candidate will have extensive experience in enrollment and a graduate degree.

Qualifications

• 7-9 years of Duals / Medicare enrollment experience required.
• 10+ years of experience preferred.
• Experience with Medicaid and Medicare regulations is a plus.

Responsibilities

• Responsible for processing and maintaining member enrollment records.
• Verifies enrollment status and resolves system rejections.
• Addresses enrollment questions via various channels.

Skills

Oversight of enrollment staff

Compliance monitoring

Data accuracy

Subject matter expertise

Policy maintenance

Education

Graduate Degree or equivalent

Job description

Be among the first 25 applicants to apply for this exciting opportunity through Lensa, the leading career site for job seekers at every stage of their career.

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 / premium related data for the 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 an equivalent combination of education and experience.

Required Experience

7-9 years of Duals / Medicare enrollment experience.

Preferred Experience

• 10+ years of experience.
• Experience with Medicaid and Medicare regulations.

Current Molina employees interested in this position should apply through the intranet job listing.

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

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

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

Seniority level

• Director

Employment type

• Full-time

Job function

• Education and Training

Industries

• IT Services and IT Consulting