Enrollment Manager

Company: Elderwood Health Plan
Location: Tonawanda
Posted on: October 8, 2021

Job Description:

Join Our Team: Put the CARE back in CAREER - Join our team today! Overview:

Immediate opening for an Enrollment Manager in Buffalo, NY!  Elderwood Health Plan, a managed medicaid provider plan, is currently seeking an Enrollment Manager to join our growing team of professionals!

The primary purpose of the Enrollment Manager is to have direct oversight of the Enrollment Department, including staff and new census. The Enrollment Manager will operationalize the regulatory requirements to successfully enroll new members into the health plan, as well as monitor and enforce compliance with enterprise-wide processes and develop/update workflows for all direct staff to follow within the Enrollment Department.

• Train, supervise, coach all Enrollment Coordinators and ensure their compliance with policy
• Ensure alignment between internal policies and changing regulatory guidance
• Identify operational items that could be improved or changed, as well as diagnose the current situation and problem solve with various departments and staff
• Provide reports and updates as scheduled or requested
• Identify barriers to the intake process and develop solutions to timely resolve
• Participate in process improvement initiatives to improve enrollment operations
• Ensure that all enrollment and disenrollment activities are documented accurately in the member electronic health record
• Communicate with RN Care Managers and outside vendors regarding scheduling of initial UAS assessments
• Oversight and help with submission of all potential enrollments/disenrollments to the New York State broker, MAXIMUS
• Maintain relationships with referral sources and community resources
• Understand the compliance and regulatory guidelines for NYS MLTC enrollment
• Ensure the timely and accurate delivery and maintenance of new and existing enrollment data
• As needed, select and recruit staff, ensuring candidates are a fit for team in terms of business need and company objectives; ability to take appropriate personnel actions when required
• Monitor the overall performance of the enrollment team on a daily, weekly, monthly basis
• Give the enrollment team direction and prioritize appropriately
• Regularly analyze and report on the productivity and effectiveness of enrollment operations, along with identifying areas of improvement and recommend resolutions
• Help process calls from interested parties for potential enrollees
• Work with EMR and State Electronic Systems for new enrollment management

• Bachelor's degree
• 6 years minimum management experience
• Ability to analyze and solve diverse problems that require interpretation of administrative and/or technical issues
• Basic understanding of Health Diagnoses
• Excellent attention to detail, organizational, planning, and prioritization skills
• Ability to multitask, work independently, troubleshoot, problem solve, direct others, communicate clearly, expand ideas, and make decisions independently
• Ability to embrace change and develop workflows to support continuous improvement
• High level of proficiency required in: internet navigation, EMR (electronic medical records), and Microsoft Office (Excel, Word, Access)

Keywords: Elderwood Health Plan, Tonawanda , Enrollment Manager, Other , Tonawanda, New York