Director, Enrollment (Duals) - REMOTE

Lensa; Miami (FL); Remote; USD 97,000 - 190,000; Full time

Job summary

A leading career site is seeking a Director of Enrollment to oversee member processing and compliance within the healthcare sector. The role involves managing enrollment records, addressing inquiries, and ensuring adherence to policies. The ideal candidate will have extensive experience in Medicare and Medicaid regulations, with a Graduate Degree preferred. This full-time position offers a competitive salary and benefits package.

Benefits

Competitive benefits and compensation package

Qualifications

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

Responsibilities

• Responsible for processing and maintenance of new members and re-enrollment.
• Address enrollment questions or concerns via claims, calls, or e-mail.

Skills

Oversight

Compliance Monitoring

Data Delivery

Subject Matter Expertise

Education

Graduate Degree

Job description

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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 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. Verify enrollment status, make changes to records, research and resolve enrollment system rejections. Address a variety of enrollment questions or concerns received via claims, call tracking, or e-mail. Maintain records in the enrollment database.

Knowledge/Skills/Abilities

• Holds general oversight of enrollment and premium staff at each plan site within the 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 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: Apply through the intranet job listing if interested.

Molina Healthcare offers a competitive benefits and compensation package. Molina is 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 skills.

Additional Details

• Seniority Level: Director
• Employment Type: Full-time
• Job Function: Education and Training
• Industries: IT Services and IT Consulting

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