INTEGRA MLTC, INC.
Director, Medicare Enrollment (Finance)
Accountable for the overall success of the Integra Medicare Enrollment department
Daily coordination and collaboration with the Sales & Marketing Department ensuring timely receipt of completed Medicare Advantage enrollment applications
Manage the end to end enrollment process including:
Processing Medicare applications within the Care Compass system while adhering to Medicare enrollment regulations
Ensuring Daily Transaction Reply Reports (DTRR) are processed within the Care Compass system
Generating and fulfillment of member enrollment correspondence while ensuring compliance and accuracy of various types of member correspondence
Reconciliation of daily, weekly and monthly CMS Medicare Enrollment reporting
Review and analysis of reporting to dictate daily/weekly priorities
Reconciling eligibility discrepancies relying on your ability to arrive at a consistently compliant disposition after the analysis of information from several reference-guidance, Call Center notes, multiple databases, and telephone outreach
Identification and communication of processing performance opportunities
Provide overall leadership and accountability for the Medicare Advantage business line
Oversee and offer significant input into the annual Medicare application, bid and implementation efforts
Work directly with Senior Management to build the necessary organizational support and infrastructure to ensure operational success
Lead enrollment impacted system designs and operational procedures including best practices
Provides consultation to all internal areas regarding Medicare enrollment capabilities
Responsible for strategic and proactive hiring, performance management and coaching/mentoring/training to enhance professional development.
Responsible for development and updating of departmental policies and procedures
Qualifications:
Bachelor's degree in business, health care administration, or related field required
Skills/Abilities:
Minimum 5 years of Medicare enrollment & management experience in a health care organization
Must be proficient with CMS enrollment and eligibility regulations with proven capability to execute compliance operationally
Strong knowledge of and experience with Medicare program and regulations
Marketing experience in a health plan setting preferred
Excellent planning, organization, and analytical skills
Strong detail orientation and customer service skills
Proven record of success as a leader, including coaching and mentoring a team
Ability to work well under pressure in a complex and rapidly changing environment
Excellent verbal and written communications, presentation and interpersonal skills
Proficient with Microsoft (EXCEL, Word, PowerPoint)
Integra is an Equal Opportunity Employer and prohibits discrimination or harassment based on any characteristics protected by the laws or regulations in the locations where we operate.
If this opportunity sounds exciting and challenging to you, please click "Apply" now!