The Manager of Enrollment Services is responsible for ensuring accurate, complaint, and timely processing of enrollment transactions across Medicare Advantage, Medigap, ACA Individual Consumer, and Commercial Group channels. This includes oversight of enrollment activities conducted within IBC platforms and vendor systems such as Advantasure, Health Rules/Proof, PBM systems, mPulse/H3O, the EDI Portal, and related solutions.
This role oversees teams that support manual enrollment requests from all lines of business from both internal (Customer Service, Sales) business partners and external (Brokers) customers; received via email, One Hub, SNOW and workbaskets.
Responsibilities:- Effectively manages the inventory received from all sources with the supervisors, including but not limited, to the mailbox, e-mail to One Hub, Report Center, SNOW, vendor applications and the queues. Applies strategies to manage the inventory in under five days.
- Analyze operational metrics to ensure corporate and divisional goals are met, including performance and process efficiency.
- Assist the Director in establishing strategic directions for Enrollment Services and broader operational initiatives.
- Develop and maintain Enrollment Services policies and procedures, ensuring Director-level approval and organization-wide communication.
- Ensure adequate staffing, training, and skill development for new and current team members.
- Foster a collaborative team environment that promotes productivity, accountability, and engagement.
- Monitors that the supervisors apply their coaching and counseling skills when needed and apply corrective action when necessary.
- Manages daily huddles with the supervisors to plan inventory and priorities.
- Analyzes all aging and repetitive inquiries to determine root cause and works with business partners to find and implement solutions to resolve.
- Responds timely to customer RFPs and Performance Guarantees.
- Prepares and analyzes required data to determine if all corporate and divisional goals are being met to include operational efficiencies.
- Represent the Director in meetings when needed.
- Perform other duties as assigned.
Education and Experience:- Minimum 6+ years of experience in operational or health plan enrollment environments.
- Minimum 3 years of direct supervisory or people-leadership experience.
- Working knowledge of Medicare Advantage and Commercial enrollment regulations strongly preferred.
- Demonstrated experience with federal/state health insurance regulations, enrollment processing, and operational policy development.
- Proven experience leading teams and managing cross-departmental initiatives.
Knowledge and Skills:- Strong understanding of data processing, operational workflows, and documented procedures.
- Proficiency in Microsoft Office applications (Excel, Word, PowerPoint; Visio and SharePoint preferred).
- Excellent written and verbal communication skills.
- Strong leadership, decision-making, analytical, and strategic-thinking abilities.
- Ability to manage competing priorities, meet deadlines, and drive continuous improvement.
- Experience with Advantasure, Health Rules/Proof, Zelis, Web Integration platforms, EDI enrollment portals, and productivity tracking systems.
Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.
