Manager, Enrollment Operations

Job Summary:The Manager, Enrollment Operations provides leadership and direction to the Enrollment team to ensure the goals and standards of the department, and CareSource, are met.Essential Functions:Understand enrollment end to end processes and able to comprehend impact of any enrollment issues to various departments in the organizationResponsible for quality of outputs and operational efficiency of the teamResponsible for managing staff to ensure timely, accurate and high quality completion of service items for internal customersOversee the financial and member enrollment reconciliation for assigned lines of businessOversee vendor eligibility extract processes to ensure accurate and timely processing of eligibility dataResponsible for complying with and meeting all regulatory requirements assigned to their teamManage enrollment technology and process analysts and associated activities involving 834 or Daily Translation Reply Report (DTRR) file processes and departmental P&P'sManage all enrollment audit engagements to ensure accurate and timely response. As necessary, develop and implement corrective action plans to address audit resultsGather, analyze, and report data related to the performance of the department and make recommendations for process improvement(s)Actively participate in ongoing development of new products and technologiesManage daily operations and projects through effective allocation of resourcesDevelop and maintain an in-depth knowledge of the company's business and regulatory environmentsIncorporate effective change and risk management controlsResponsible for hiring, training, coaching and developing direct reports including completing performance appraisals and disciplinary actionsMentor team leads and team members to produce consistent, high quality deliverablesPerforms any other job related duties as requested.Education and Experience:Bachelor's degree required Equivalent years of relevant work experience may be accepted in lieu of required educationThree (3) years of leadership/management experience required Three (3) years of enrollment/reconciliation/call center experience required Competencies, Knowledge and Skills:Strong understanding of health plan enrollment processesExpert proficiency in Facets subscriber and member setup, benefits eligibility [including COB], and proficiency in the Customer Service application is preferredKnowledge of Medicaid, Medicare, and Dual coverage programs, including enrollment requirements and regulatory complianceUnderstanding of HIPAA 834, EDI 270/271, DTRR, MMR, and other industry-standard enrollment files and data exchange processesKnowledge of enrollment reconciliation is preferredStrong Knowledge of regulatory reporting and compliance requirements is preferredProficient in use of online services to verify member eligibility for each CareSource program, and internal and external eligibility search functionsEffective people management/leadership skillsStrong knowledge of database management desiredKnowledge of working with IT teams and providing requirementsAbility to effectively prioritize and execute tasks in a high-pressure environmentAbility to defuse tension and manage conflict among and between teams and membersAdvanced communication skills (both written and verbal) and ability to work with multi-disciplinary departments across the organizationExcellent mentoring and coaching skillsPersuasive, encouraging, and motivatingExcellent decision making/problem solving skillsStrong critical thinking and listening skillsAnalytical thinkingLeads by exampleActively gathers appropriate level of participation and input to decision-making and fosters it within teamsFocuses and aligns actions and decisions on ways to enhance service and Member experienceLicensure and Certification: None required Working Conditions:General office environment; may be required to sit or stand for extended periods of time Travel is not typically requiredCompensation Range:$83,000.00 - $132,800.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.Compensation Type:SalaryCompetencies:- Fostering a Collaborative Workplace Culture - Cultivate Partnerships - Develop Self and Others - Drive Execution - Influence Others - Pursue Personal Excellence - Understand the BusinessThis job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.#LI-SD1