Director, Enrollment (Duals) - REMOTE

Lensa; Rio Rancho (NM); Remote; USD 97,000 - 190,000; Full time

Job summary

A leading career site is seeking a Director for enrollment processing at Molina Healthcare. This role involves overseeing member enrollment records, ensuring compliance with regulations, and managing staff. The ideal candidate will have extensive experience in Medicare and Medicaid enrollment, along with a graduate degree.

Benefits

Competitive benefits package

Qualifications

• Graduate Degree or equivalent combination of education and experience.
• 7-9 years of duals/Medicare enrollment experience required.
• 10+ years preferred, including Medicaid and Medicare regulations.

Responsibilities

• Responsible for preparation and maintenance of member enrollment records.
• Oversees enrollment and premium staff, ensuring compliance.
• Serves as subject matter expert for projects related to enrollment.

Skills

Leadership

Compliance Monitoring

Data Management

Problem Solving

Education

Graduate Degree

Job description

Be among the first 25 applicants to this job and get AI-powered advice and exclusive features on Lensa, 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, 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, and 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 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, including Medicaid and Medicare regulations.

Additional Information

To all current Molina employees: Please apply through the intranet job listing if interested. 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 skills.

Additional Details

• Seniority level: Director
• Employment type: Full-time
• Job function: Education and Training
• Industries: IT Services and IT Consulting