Client is seeking a Director, Enrollment.
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 mailhouse
* 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
Education/Experience: 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.