This position is responsible for managing the day-to-day functions of the member enrollment department and ensuring timely and accurate processing of enrollment transactions. The position will lead a business team that supports the delivery of enrollment and eligibility requirements for new client implementations and to meet ongoing client needs. This individual will lead the business team on the delivery and execution of critical enhancements supporting enrollment and eligibility. Ensures team manages performance guarantees, operational goals, and turnaround times.
Assesses current state of eligibility and identify gaps and improvements.
Supports day to day operations, new implementations, and projects for eligibility operations.
Reports performance results to team and management.
Obtains an in-depth working knowledge of the eligibility department's workflow and the impact to other departments.
Adheres to budget allocations.
Manages team performance and provides feedback to individuals.
Recognizes and rewards effectively; maintains a positive work environment.
Provides appropriate level of directions and support to team.
Identifies training needs and executes as needed.
Manages schedules, time off requests, timesheets, overtime, etc.
Provides backup to support staff to ensure metrics are always maintained.
Trains new employees and provides continuous trainings as needed for all employees
Provides clear and timely communications to team.
Maintains documentation for all processes and accounts.
Team audits.
Special projects as assigned.
Other Job Requirements
Responsibilities
5+ years of progressive experience with Member Enrollment and Eligibility business operations, preferably at a health plan, managed care organization, third-party administrator, or other healthcare entity.Bachelor's in relevant area or a combination of education and experience.Strong working knowledge of claims, prior authorizations, EDI 834 transactions and member enrollment operations.Strong analytical and organizational skills.Ability to work collaboratively across partner/organizations.Models leadership and takes initiative.Ability to easily manage and be flexible to fluctuations in demand of work and growth; effectively manage by reporting and strategizing on resource needs.Exceptional problem solver with the ability to handle difficult situations; proven ability to remain calm in the face of a challenge and comprehension of when and how to escalate an issue.Exceptional dynamic listening, communication, and presentation skills.
General Job Information
Title
Manager, Enrollment Services
Grade
25
Work Experience - Required
Management/Leadership, Operations
Work Experience - Preferred
Education - Required
A Combination of Education and Work Experience May Be Considered., Bachelors
Education - Preferred
License and Certifications - Required
License and Certifications - Preferred
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.
Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.
Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .
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Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.
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