Director of Enrollment

$108K - $144K
Posted on 10/28/17 by Arthur Crume
Confidential Company
Rancho Cordova, CA
Staffing & Recruiting
$108K - $144K
Posted on 10/28/17 Arthur Crume

Director of Enrollment

*Must have a degree, strongly prefers MBA.

*7+ years of managed care or government programs preferred.

*Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.

*Will have 4-6 direct reports but be responsible for a team of 120-150 employees.

Rancho Cordova, CA

Position Purpose:

Provide strategic direction for all enrollment functions by providing technical and leadership support.

Oversee enrollment functions to ensure that all efforts are parallel with the mission and objectives of the plan.

Oversee the Eligibility and Enrollment department staff.

Establish working relationships with external sources with Health & Human Services Commission (HHSC), state enrollment broker and other local state offices.

Collaborate with internal operations teams to identify efficient solutions to meet business needs related to enrollment and facilitate continued process improvement.

Establish and maintain liaison relationships with corporate IT to support and facilitate the common goals and objectives related to enrollment and eligibility services.

Design and test new codes sets and processes for new product implementation to include business rule integration and state contract compliance.

Manage and establish file interchanges with external vendors and affiliates including the mail house.

Direct resolution to state complaint trends related to enrollment and eligibility.

Represent the health plan in state MIS meetings.

Develop and implement a reconciliation process of enrollment and financial records.

Direct the eligibility load process while coordinating with corporate IS department to resolve issues that arise during the process.

Coordinate monthly reconciliation process of remittance files by resolving discrepancies in the report.

Qualifications:

*Bachelor's’ degree in related field or equivalent experience.

*7+ years of managed care or government programs preferred.

*Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.

Equal opportunity employer that is committed to diversity, and values the ways in which we are different.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

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