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Manager of Enrollment & Membership

Job Ref: 90874
Department: ENROLLMENT & MEMBERSHIP
Location: Downtown NYC

In Person: 2-3 days per week
Salary Range: $95,000.00 – $107,000.00

About Client

Cure Staffing, Inc, DBA Cure the Executive Edge has partnered up with one of NYC’s most prevalent and prestigious insurance providers. Our client provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, and network including primary care providers, specialists and participating clinics. Over the last three decades, our client has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life and we are excited to help them accomplish this goal. We are seeking qualified, appropriately skilled professionals who can provide reliable and professional support. All candidates must have education, experience, licenses, and certifications that are applicable and appropriate to the level of this position.

Position Overview

Under the direction of the Director of Enrollment and Membership (E&M), the Manager of Enrollment & Membership will be responsible for the day-to-day operations of the department, departmental statistical reporting, establishing, and maintaining departmental policies and processes and management of the departments’ administrative functions.

Job Description

  • Overall management of the day-to-day operations of the Enrollment and Membership Department.
  • Work with the Director of E&M to identify key areas for automation, prioritize opportunities for process improvement and ensure the impact to other departments is identified and communicated.
  • Manage the implementation of process improvement, as appropriate.
  • Develop data integrity reports to monitor the work of the staff for efficiency, effectiveness, and quality.
  • Develop, edit, and promote use of established standardize desktop workflows/processes.
  • Responsible for maintaining up to date productivity records on a daily and monthly basis for departmental dashboards.
  • Serve as point of escalation with internal and external stakeholder as necessary to resolve issues.
  • Regularly analyze and report on the productivity and effectiveness of the operations in comparison to established KPI/SLA to ensure all the department’s objectives are met.
  • Identify areas for automaton to mitigate human error.
  • Perform root cause analysis of identified processing issue and determines the need for training or process changes.
  • Collaborates with Director in matters involving policy interpretation and exceptions to existing policy and procedure.
  • Resolve departmental problems, concerns, or issues.
  • Responsible for ensuring the integrity of information being entered & maintained within the organization’s internal enrollment systems.
  • Work with plan staff to resolve enrollment and disenrollment issues.
  • Ensure that all regulatory changes are communicated and implemented in a timely fashion.
  • Ensure that staff is adequately trained.
  • Oversee the department’s returned mail process.
  • Other responsibilities as directed.

Minimum Qualifications

  • Bachelor’s Degree required; Master’s Degree in Business Administration preferred
  • Minimum three years of management experience in health care enrollment operations, preferably in a managed care environment; And
  • Minimum three years of demonstrated experience in employee development and performance management;
  • Demonstrated ability to develop workflows, policies, and procedures
  • Demonstrated ability to identify opportunities for improvement and implement solutions
  • Knowledge in (Medicaid, QHP, EP, CHPlus, Gold, MAP) enrollment policies

Professional Competencies

  • Intermediate proficiency in Microsoft Suite (Visio, Excel, PowerPoint, Word)
  • Integrity and Trust
  • Customer Focus
  • Excellent verbal and written communication skills
  • Excellent interpersonal skills
  • Detail oriented with the ability to manage multiple assignments simultaneously
  • Ability to apply critical thinking skills
  • Ability to work independently
  • Ability to adapt to changing priorities, meet deadlines, and work well under pressure

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