Director, Enrollment (Duals) - REMOTE

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

Job summary

An established industry player is seeking a dedicated professional to oversee enrollment processes and maintain accurate records. This role involves managing a team, ensuring compliance with regulations, and serving as a subject matter expert in enrollment matters. You will be responsible for preparing and processing member records, addressing inquiries, and maintaining the enrollment database. Join a dynamic environment that values your expertise and offers a competitive compensation package, making a significant impact in the healthcare sector.

Qualifications

• 7-9 years of duals / Medicare enrollment experience required.
• Graduate degree or equivalent education/experience needed.

Responsibilities

• Prepare, process, and maintain new members and re-enrollment.
• Verify enrollment status and resolve system rejections.

Skills

Enrollment Oversight

Compliance Monitoring

Data Accuracy

Policy Maintenance

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, 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 email. Maintain records in the enrollment database.

Knowledge/Skills/Abilities

• Holds general oversight of enrollment and premium staff at each plan site within a defined region. This may include 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.
• 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.

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 from posting based on geographic location, work experience, education, and/or skill level.

Seniority level

• Director

Employment type

• Full-time

Job function

• Education and Training

Industries

• IT Services and IT Consulting