Enrollment & COB Manager

PrimeWest Health; Alexandria (MN); Presencial; USD 85.000 - 115.000; Jornada completa

Descripción de la vacante

PrimeWest Health in Alexandria, MN is seeking an Enrollment & COB Manager responsible for overseeing enrollment operations and coordination of benefits for plan members. This full-time role supervises staff, refines policies, and ensures compliance with state and federal regulations related to MHCP.

You will collaborate with member services, claims, and provider relations, analyze data to identify trends, implement process improvements, and support audits and reporting to maintain quality

Formación

• Experience with health plan enrollment, eligibility, and COB processes.
• Knowledge of Medicaid, Medicare, and Minnesota Health Care Programs and related agencies.
• Strong analytical and problem-solving abilities with data review and reporting.
• Bachelor’s degree or equivalent combination of education and relevant work experience.

Responsabilidades

• Oversee enrollment workflows and COB processes to ensure accurate, timely coverage for plan members.
• Supervise staff and refine policies and procedures related to enrollment and COB.
• Collaborate with internal departments (member services, claims, provider relations) and external partners.
• Analyze data to identify trends, implement process improvements, and support audits and reporting.

Conocimientos

Team leadership

Analytics

Communication

Problem solving

Project coordination

MS Office

Educación

Bachelor’s degree in business, health administration, public health, or related field

Herramientas

Enrollment systems

Claims systems

MS Office

Descripción del empleo

Company Description

PrimeWest Health is a partnership of 24 rural Minnesota counties that collaborate to provide health coverage solutions for individuals eligible for Minnesota Health Care Programs (MHCP). The organization currently offers coverage to more than 76,000 residents across 24 counties, supported by a network of over 12,600 medical and social service providers spanning Minnesota and neighboring states. With more than 190 employees, PrimeWest Health is a major employer in the Alexandria, MN area and provides competitive salaries and benefits. As a full-service health plan, team members work in areas such as enrollment and member services, care coordination, provider network management, claims processing, information systems, and regulatory compliance. PrimeWest Health emphasizes excellence, innovation, and community-focused service in all aspects of its operations.

Role Description

The Enrollment & COB Manager is responsible for overseeing enrollment operations and coordination of benefits (COB) processes to ensure accurate and timely coverage for plan members. This full-time role is based in Alexandria, MN. Day-to-day responsibilities include managing enrollment workflows, monitoring eligibility updates, and ensuring compliance with state and federal regulations related to Minnesota Health Care Programs. The role involves supervising staff, developing and refining policies and procedures, collaborating with internal departments such as member services, claims, and provider relations, and serving as a subject matter resource for enrollment and COB issues. The manager also analyzes data to identify trends, implements process improvements, and supports audits and reporting requirements to maintain high-quality service and operational efficiency.

Qualifications

• Experience with health plan enrollment, eligibility, and coordination of benefits processes, preferably within public health care programs or managed care settings.
• Knowledge of regulatory requirements related to Medicaid, Medicare, and Minnesota Health Care Programs, and familiarity with agencies such as MDH, DHS, CMS, and NCQA.
• Skills in team leadership, staff supervision, and performance management, with the ability to coach, develop, and support a diverse team.
• Strong analytical and problem-solving abilities, including experience with data review, reporting, and process improvement initiatives.
• Proficiency with enrollment and claims systems, general office software (e.g., MS Office), and comfort working with electronic health plan data.
• Excellent written and verbal communication skills, with the ability to collaborate effectively across departments and with external partners.
• Detail-oriented and highly organized, with the ability to manage multiple priorities and meet deadlines in a regulated environment.
• Bachelor’s degree in business, health administration, public health, or a related field, or equivalent combination of education and relevant work experience.
• Prior experience in a health plan, health care