Intake & Enrollment Manager

Bethesda Group; Colorado Springs (CO); On-site; USD 65,000 - 75,000; Full time

Benefits offered by this job

Medical and Prescription Drug

Dental

Vision Care

Wellness Program

Telemedicine Program

401(k) Savings Plan

Life Insurance

Job summary

Rocky Mountain PACE is seeking an Intake and Enrollment Manager to supervise the Enrollment and Eligibility teams, streamline intake and enrollment processes, and ensure accurate data entry and timely eligibility determinations.

You will coordinate with leadership to maintain Medicaid/Medicare enrollment and compliance, while coaching staff and driving monthly census goals in a patient-centered program.

Qualifications

• Bachelor's degree in a related field preferred or equivalent experience.
• 3 years healthcare experience with elderly population required.
• Knowledge of Medicaid/Medicare processes is highly desired.

Responsibilities

• Leads and supervises enrollment teams to meet monthly goals.
• Oversees intake processes, eligibility screenings, home visits, and enrollment.
• Monitors data entry accuracy and improves enrollment workflows.
• Handles staff hiring, onboarding, training, and performance reviews.
• Ensures CMS/HCPF compliance and reporting requirements.

Skills

Effective Supervision

Strategic Focus

Communication

Problem Solving

Team Leadership

Education

Bachelor's degree in Human Services/Healthcare Admin/Business

Job description

Job Details: Job Location: Colorado Springs Explorer Location - COLORADO SPRINGS, CO 80920, Position Type: Full Time, Salary Range: $65,060.00 - $74,819.00 Salary,

POSITION SUMMARY

Under the direct supervision of the Director of Enrollment and Retention, the Intake and Enrollment Manager is responsible for the management of the Intake and Enrollment department at Rocky Mountain PACE. This position oversees the participant intake process including home and center visits, data gathering for Intake and assessment process, and enrollment meeting. This position monitors and improves the process for participants and families applying for Rocky Mountain PACE program, while ensuring currently enrolled participants maintain their ongoing Medicaid/Medicare.

CORE COMPETENCIES

• Effective Supervision
• Balanced Decision Making
• Strategic Focus
• Manages Conflict
• Effective Communication
• Facilitates Change
• Problem Solving
• Quality Focus
• Personal Credibility
• Decisiveness

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

• Leads, coordinates, and supervises the PACE Enrollment and Eligibility teams to ensure monthly goals are met.
• In coordination with the Director of Enrollment and Retention, evaluates, develops, and implements the enrollment process and procedures. Including but not limited to: phone eligibility screenings, initial screenings and assessments in the home of potential participants, education and enrollment assistance activities to determine participant needs and eligibility for enrollment. Reviews appropriate documentation related to participant assessments as required.
• Consistently monitors, audits, reviews PACELogic to ensure Enrollment team enters data promptly and accurately. Based on results, develops and implements processes and workflows for maximum accuracy.
• Evaluates and updates the intake process, streamlining for efficiency
• Coordinates completion of appropriate paperwork to help participants qualify for PACE
• Ensures that intake staff provide referral services for persons not eligible for the PACE program
• Is responsible for hiring, onboarding, training, development, and performance management of staff
• Monitors expenditures with commitment to good stewardship of the organization’s resources
• Completes all other assignments as directed by the Director of Enrollment and Retention
• Maintains verbal and written skills required for the position
• Attends meetings and participates in committees as required
• Completes annual trainings as required
• Monitors the Enrollment team’s productivity throughout the month and ensures that monthly enrollment goals are met. When goals are not met, provides coaching and feedback to maximize overall productivity.
• Ensures a positive experience for potential enrollees, candidates, and their family members. Provides responsive, high-quality service to participants and others who interact with the Intake and Enrollment team.
• Provides accurate, complete and up to date information in a courteous, efficient and timely manner.
• In conjunction with the Director of Enrollment and Retention, plans and develops participant engagement strategies to assist in onboarding and retaining participants by providing the maximum level of customer service. Strategies can include but not limited to: 90 day Enrollment Representative involvement, strategies to engage existing participants, continued education to existing participants concerning PACE benefits.
• Monitors "within our control" disenrollments and creates reports to account for any potential service failures. In conjunction with the Director of Enrollment and Retention, reports findings to PACE leadership for resolution and prevention of future disenrollments.
• Oversees the Eligibility Advocates and Lead to ensure Medicare and Medicaid eligibility reports for all active PACE participants are completed routinely. Addresses and remedy all eligibility issues that can impact existing participant's program eligibility. Provides accurate and thorough eligibility reports to the Director of Enrollment and Retention, Finance Department and PACE leadership as required.
• Ensures compliance with all applicable CMS (Centers for Medicare & Medicaid Services) and Colorado Department of Healthcare Policy and Financing (HCPF) policies, rules, and regulations.
• Assists with developing policies, procedures, and standards for department activities.
• Maintains a safe, secure, and legal work environment and ensures development of personal growth opportunities.
• Meets monthly and annual PACE census goals.
• Ensures 100% of participant RRR and CSRs completed for department on an annual basis.
• Maintains department annual closure rate of less than 5%.
• Attends at least one continuing education workshop per quarter to enhance knowledge in Medicaid/Medicare or to keep abreast of changes in federal/state regulations.

Other Duties

• Perform other duties and special projects as assigned that are consistent with the scope and responsibilities of the position.

ORGANIZATIONAL EXPECTATIONS

• Demonstrates support of the Company's Mission, Vision and Core Values
• Provides Exceptional Customer Service
• Ensures discretion with confidential information in accordance with HIPAA guidelines
• Supports a collaborative work environment including courteous, helpful and professional behavior
• Embraces Organizational Excellence through practicing individual time management, efficiency and effectiveness and participating in continuous improvement efforts
• Adheres to and supports all Company policies and procedures
• Supports and practices safe work habits in accordance with policies and procedures
• Brings ideas, problems and concerns forward and participates in resolution and implementation
• Participates in and completes regulatory compliance trainings within the prescribed deadlines
• Attends required meetings
• Demonstrates appropriate level of time management in support of co-workers and the entire team
• Maintains skills and knowledge required including written and verbal communication, best practices for industry standards, and computer competency

Managerial Breadth/Scope of Job

• Exercises independent judgment and decision-making authority over departmental staffing, resource allocation, and escalating matters outside delegated authority to the appropriate position.
• Responsible for the overall orientation, counseling/coaching, training, scheduling, performance reviews and disciplinary actions (with HR assistance) in a timely manner.
• Assigns tasks fairly and appropriate to job responsibilities.
• Communicates goals and expectations clearly and effectively with direct reports.

Qualifications

• Bachelor's degree in Human Services, Healthcare Administration, Business or related degree strongly preferred, or equivalent combination of education and experience.
• 3 years of health care experience working with frail and/or chronically ill elderly population required
• 2 years case management experience, including interviewing and/or assessment required
• Knowledge of Long-Term Medicaid services required
• Knowledge of community resources available to seniors and their families highly desired
• Must have excellent written and verbal communication skills and demonstrate the ability to interact clearly and effectively with both internal and external customers

We strive to provide our employees with a comprehensive and affordable benefits package.

• Medical and Prescription Drug
• Dental
• Vision Care
• Wellness Program
• Telemedicine Program
• Flexible Spending Accounts
• Health Savings Account
• Company Paid Basic Life and Accidental Death & Dismemberment
• Company Paid Long-Term Disability
• Voluntary Life Insurance
• Voluntary Short-Term Disability
• Accidental Injury Insurance
• Critical Illness
• Hospital Indemnity
• 403(b) Savings Plan
• Legal Shield and IDShield
• Employee Assistance Program (EAP)
• Paid Time-Off plan

Such benefits are based on applicable state law and factors such as pay classification (full-time, part-time, or casual), job grade and length of service.