Enrollment Operations Leader

CareSource; Northern (KY); Hybrid; USD 83,000 - 133,000; Full time

Job summary

CareSource seeks a Manager, Enrollment Operations to lead the Enrollment team and ensure the department meets its goals and CareSource standards. The role requires knowledge of end-to-end enrollment processes, regulatory compliance, and data-driven improvement initiatives.

The candidate will oversee data reconciliation, eligibility processing, and audit engagements while guiding staff development and performance management in a dynamic health plan environment.

Qualifications

• Bachelor's degree required.
• Three (3) years of leadership/management experience.
• Three (3) years of enrollment/reconciliation/call center experience.

Responsibilities

• Provide leadership and direction to the Enrollment team to ensure goals and standards are met.
• Ensure timely, accurate and high-quality outputs for internal customers.
• Oversee enrollment data reconciliation and eligibility processing for assigned lines of business.
• Ensure compliance with regulatory requirements assigned to the team.
• Manage enrollment technology and processes involving 834 or DTRR file processes and related PSOs.
• Oversee enrollment audits and implement corrective actions as needed.
• Analyze department performance data and recommend process improvements.
• Mentor and develop staff; lead performance evaluations and coaching.

Skills

Leadership/people management

Enrollment processes

HIPAA & regulatory compliance

Facets subscriber setup

Benefits eligibility COB

Data analysis

Education

Bachelor's degree

Tools

Facets

Customer Service application

Job description

CareSource seeks a Manager, Enrollment Operations to lead the Enrollment team and ensure the department meets its goals and CareSource standards. The role requires knowledge of end-to-end enrollment processes, regulatory compliance, and data-driven improvement initiatives.

The candidate will oversee data reconciliation, eligibility processing, and audit engagements while guiding staff development and performance management in a dynamic health plan environment.