Enrollment Operations Lead - Medicare & Regulatory

Dale WorkForce Solutions; Philadelphia (Philadelphia County); On-site; USD 70,000 - 90,000; Full time

Job summary

Dale WorkForce Solutions is seeking a Manager of Enrollment Services in Philadelphia, PA. This role is responsible for overseeing the accurate and compliant processing of enrollment transactions across various channels.

Key responsibilities include ensuring Medicare Advantage reconciliation, leading a team of analysts, and maintaining adherence to federal and state regulations. Ideal candidates will have extensive experience in operational environments and possess strong leadership skills.

Qualifications

• 4+ years of experience in operational or health plan enrollment environments.
• 2+ years of direct supervisory or people leadership experience.
• Working knowledge of Medicare Advantage and Commercial enrollment regulations strongly preferred.
• Strong understanding of data processing and operational workflows.

Responsibilities

• Ensure all Medicare Advantage enrollment activity is fully reconciled.
• Oversee accurate and timely submission of reports to regulatory agencies.
• Act as the enrollment and reconciliation lead for onsite regulatory audits.
• Analyze operational metrics to ensure corporate goals are met.
• Develop and maintain Enrollment Services policies and procedures.

Skills

Operational management

Regulatory compliance

Data analysis

Leadership

Medicare Advantage knowledge

Tools

Advantasure

HealthProof

EDI enrollment portals

Productivity tracking systems

Job description

Dale WorkForce Solutions is seeking a Manager of Enrollment Services in Philadelphia, PA. This role is responsible for overseeing the accurate and compliant processing of enrollment transactions across various channels.

Key responsibilities include ensuring Medicare Advantage reconciliation, leading a team of analysts, and maintaining adherence to federal and state regulations. Ideal candidates will have extensive experience in operational environments and possess strong leadership skills.