Supervisor - Enrollment

Employment Type

: Full-Time

Industry

: Non-Executive Management



PURPOSE OF THE POSITION:
Manage the day to day operations of the Enrollment Department core systems integration team. Provide direction and support to staff through work prioritization. Oversee and participate in problem and issue resolution and the development of workflows and processes. The Enrollment core supervisor will plan and distribute workloads to staff on a daily basis to meet all processing deadlines and is accountable for maintaining optimal workflow. Follow organization standards, by ensuring the effective delivery of high quality service to continue to grow the companys membership, identify problems, examine solution options, implement action plans, provide resources to recommend policies, and resolve quality issues.
ESSENTIAL FUNCTIONS:
Oversee and support prompt and accurate enrollment into Affinity Health Plan Members with problematic eligibility.
Monitor the performance of tasks as required by researching, analyzing and resolving process issues and/or
communicating with various agencies. Ensure internal systems are in synchronicity with State core systems.
Oversee and monitor the review, analysis and resolution of individual membership issues originating from various sources (e.g. Maximus, ePaces, Member Services, Claims, etc.).
Thorough knowledge of Facets, Maximus, HRA/LDSS, State Roster, claims and billing.
Create and monitor resolution outcomes, analysis and evaluation of existing procedures. Communicate procedural concerns and recommendations to the appropriate management to enhance accuracy, efficiency
and productivity.
Participate in the ongoing evaluation and update of the configuration of the Facets as it relates to the roster process and spans.
Participate in the ongoing evaluation and update of the configuration of the corporate operating system (system) as it relates to departmental processes.
Assist in System training for incumbent employees and new hires, as directed.
Collaborate with CAS Business Analysts on the development, updating and maintenance of System user manuals.
Design and advice on reporting needs and help design and test reports that meet the evolving needs of the Enrollment department and Marketing and Membership division.
Perform other duties as delegated, assigned or required.
QUALIFICATIONS:
Associates Degree or equivalent experience in managed care or related field required. BA/BS degree preferred.
A minimum of two years managed care experience, preferably with analytical or systems exposure.
Highly developed organizational, problem solving and prioritization skills.
Strong analytical skills and detail orientation.
Strong verbal and written communication skills demonstrated by the effective communication of detailed
information in logical and understandable sequence.
Good interpersonal skills reflective of sensitivity and tact.
Intermediate level proficiency with Microsoft Office (Word, Excel, Power Point, etc.) and knowledge of Microsoft Project and Visio.
Demonstrated ability to perform analysis and identify solutions to resolve specific business issues.
Demonstrated ability to work independently and proactively.
Resourcefulness required defining or refining procedures, ideas or processes.
Demonstrated ability to function as part of a team.

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