Director, Enrollment (Duals) - REMOTE

Lensa; Warren (MI); Remote; USD 97,000 - 190,000; Full time

Job summary

A leading healthcare company in Michigan is seeking an experienced professional responsible for managing enrollment processes and maintaining accurate records. The role involves oversight of enrollment staff, compliance monitoring, and acting as a subject matter expert. Ideal candidates will have extensive experience in Medicare and Medicaid regulations.

Qualifications

• 7-9 years Duals / Medicare enrollment experience.
• 10+ years Medicaid and Medicare Regulations experience.

Responsibilities

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

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 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 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 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.