Enrollment Supervisor Medicare

The Enrollment Supervisor, Medicare (MMP) oversees the day-to-day operational activities and staff of the Enrollment department. The Enrollment Supervisor also works with customers, vendors, and with federal and State agencies to resolve eligibility issues in order for the plan to ensure no access to care issues for our membership and for the plan to continue receiving payment for services provided. Responsible for escalating to and supporting the Director in assimilating the companys entire enrollment picture and representing an integrated view in discussions with upper management and external partners to meet the mission, vision and values of the company.

Duties and Responsibilities

Responsibilities include, but are not limited to, the following:

• Engage in on-going performance management of staff including coaching, mentoring, development, training and succession planning to include hiring and termination decisions
• Supervise, review, monitor, and control enrollment reconciliation operation with efficiency and effectiveness.
• Assist with the design/revision and implementation of internal departmental systems and procedures.
• Supervise and ensure the submission and monitoring of daily, weekly and monthly inventory reports to determine departmental efficiency and maintain the integrity of the enrollment file/ data.
• Assist with the strategic future planning of the enrollment function. Ensuring the Enrollment function has sufficient capacity and growth to support new business.
• Assist with the coordination of interdepartmental projects with other areas of the organization; including Business Systems and EDI Analysis, Marketing departments, Compliance, and Member Services.
• Prepare enrollment analysis and enrollment reports for the Director of Business Services.
• Collaborate with the Director of Business Services on the implementation of Medicaid and ACA regulations and related products.
• Serves as a subject matter expert and coordinating departmental procedures.
• Ensures compliance with company and statutory policies.
• Contributes to departmental policy and procedural documentation.

• Ensures the required member mailings are sent in a timely fashion.
• Performs other duties as assigned
• Corporate Compliance Responsibility - As an essential function, responsible for complying with Neighborhoods Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents

Qualifications:

Required:

• Associates degree in Business or Health related area or equivalent education and relevant work experience to equate to the degree
• Five (5) years Medicaid HMO experience preferably in an enrollment position
• EDI experience
• Communication skills, including excellent writing abilities
• Excellent computer skills, including Microsoft Word and Excel
• Organizational skills and reporting experience
• Analytical and reconciliation skills
• Ability to work independently, as a team player and exhibit necessary leadership skills
• Strong attention to detail
• Problem solving and work load management skills
• Ability to handle multiple responsibilities simultaneously
• Ability to work cross-functionally across different departments in the organization

Preferred:

• Bachelors degree
• Experience managing or mentoring staff

Neighborhood Health Plan of Rhode Island is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.