Vice President, Enrollment and Eligibility
About The RoleThe Vice President of Enrollment and Eligibility is responsible for providing strategic direction and management of the Enrollment and Eligibility Department. The VP will be a highly motivated leader with a demonstrated track record of success meeting or exceeding established objectives, leveraging a high performance team. The VP will be expected to ensure their department’s adherence to all existing processes and procedures while also identifying areas for efficiency and enhancement. This requires the VP to oversee and monitor all performance related metrics, as well as identify additional metrics that are necessary to drive accuracy and efficiency. A detailed orientated person, the VP will be responsible to ensure that all enrollment and eligibility transactions and requirements meet or exceed established service level agreements. The VP will also be required to serve as the point of contact for external facing customers, as well as oversee a service team who will be the day to day point of contact to external clients whose eligibility the department is managing.Primary ResponsibilitiesServe as the overall Subject Matter Expert within the company for the Enrollment and Eligibility responsibilityEstablish department objectives that support company goals and produce regular status reportsPrepare an operating budget that reflects the forecasted needs of the department and control expenditures to assure adherence to approved budgets. Manage expenses not to exceed the budgetEnsure effective workflows, maximize system efficiencies, monitor quality performance measures and confirm appropriate completion of work assignments. Make recommendations for change as appropriateImplement checks and balances where appropriate to drive accuracy and timeiless of the Enrollment and Eligibility processEnsure all Departmental deliverables and reporting requirements are met within the required timeframesAs the Leader of the Eligibility and Enrollment Department, serve as the point person with Leaders from dependent departments to drive cross departmentalPartner with the technology Department to drive innovation and efficiency in the Enrollment and Eligibility process, delivering high satisfaction to our clients and their membersApprove personnel actions such as hiring, disciplinary, termination and/or salary recommendationsParticipate in training, coaching and motivation of employees including career path development. Assess individual employee performance and conduct timely performance appraisalsPromote teamwork, discussion, and cooperation among staff and other departments. Ensure timely communication and sharing of information with team membersWork with staff to resolve work-related issues and concerns. Promote a respectful and diverse workplaceDevelop and maintain departmental policies and proceduresMinimum Education/Licensures/Qualifications10+ years in health insurance industry5+ year’s management experienceBachelor’s Degree in Business or Health Insurance Related FieldPreferred QualificationsMaster’s in Business Administration or Health Insurance related fieldExperience working with Taft Hartley trustsExperience with self-funded insurance plan administrationFamiliarity with ERISA rules and regulationsExperience overseeing Enrollment and Eligibility Responsibilities or a Plan or Self-Administered groupPreferred residence near Westbury, NY Office, but not requiredAboutAt Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered. When you join our team, you’ll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion and a sense of belonging at every level. Here, you’ll be encouraged to bring your authentic self to work with all of your unique abilities.Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today’s healthcare with our flexible and cutting-edge third-party administration services. Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform. As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes and achieve their healthcare goals and objectives. Together with our trusted partners, we are transforming the health plan experience with the promise of turning today’s challenges into tomorrow’s solutions.Come be a part of the Brightest Ideas in Healthcare™.Company MissionTransform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners.Company VisionRedefine health care quality and value by aligning the incentives of our partners in powerful and unique ways.JOB ALERT FRAUD: We have become aware of scams from individuals, organizations, and internet sites claiming to represent Brighton Health Plan Solutions in recruitment activities in return for disclosing financial information. Our hiring process does not include text-based conversations or interviews and never requires payment or fees from job applicants. All of our career opportunities are regularly published and updated brighonthps.com Careers section. If you have already provided your personal information, please report it to your local authorities. Any fraudulent activity should be reported to: recruiting@brightonhps.com