Director, Enrollment (Duals) - REMOTE

Molina Healthcare; Town of Texas (WI); Remote; USD 97,000 - 190,000; Full time

Job summary

An established industry player is seeking a dedicated professional to oversee enrollment processes and ensure compliance with regulations. This role involves managing a team, maintaining accurate records, and addressing enrollment inquiries. With a focus on quality and accuracy, the position offers the chance to contribute to the health and well-being of members. The company provides a competitive benefits package and values diversity in the workplace. If you have extensive experience in Medicare and Medicaid enrollment, this is an exciting opportunity to make a significant impact in the healthcare sector.

Qualifications

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

Responsibilities

• Oversee enrollment and premium staff, ensuring compliance.
• Maintain accurate enrollment and premium data for the region.

Skills

Enrollment Oversight

Compliance Monitoring

Data Accuracy

Policy Maintenance

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. 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

1. Holds general oversight of enrollment and premium staff at each plan site within defined region. This may include employee reviews, coaching sessions and disciplinary actions.
2. Monitors and enforces compliance with company-wide reconciliation processes.
3. Ensures that delivery of enrollment / premium related data is accurate for defined region.
4. Subject matter expert for projects and / or new business related to areas of oversight.
5. 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 Duals / Medicare enrollment experience.

Preferred Experience
10+ years 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 from posting based on geographic location, work experience, education and/or skill level.