Apply for this job now

Medicaid Enrollment Manager/Operations Manager. Job in Phoenix Top Essex Careers

Location
Phoenix, Arizona
Job Type
Permanent
Posted
2 Jan 2022

Medicaid Enrollment Manager

Operations Manager

Location for this position is Phoenix, AZ.



In the Operations Manager role you will Anticipate, understand, and exceed stakeholder needs and expectations by providing remarkable service in a timely manner, demonstrate open, honest, and transparent communication in all interactions, speaks, listen, convey, and share ideas in a clear, logical, and successful manner. Initiative, demonstrate and exhibit leadership qualities that include, developing skills and encouraging growth, staff involvement in planning, and process improvement, foster quality focus in others, process improvement, and provide frequent performance feedback and encourage positive participation among team members.



Responsibilities may include but are not limited to:

  • Drive operational performance of vendors for each core process to meet contractual requirements and align with the Enterprise strategic objectives.
  • Oversee day-to-day stakeholder engagement efforts including hold daily and/or weekly huddles, assess risk and remediate enrollment file management risks, drive priorities and escalation resolutions, handle Molina Healthcare service inquiries to ensure complete, accurate and timely responses.
  • Lead organizational cross-functional reviews of end-to-end enrollment processes, establish and validate workflows, identify and resolve operational gaps as - needed basis.
  • Develop, review and meet organization criteria related to enrollment operations, turnaround times, quality, regulatory and accuracy requirements. Monitor operational performance metrics ensuring plan reporting requirements are met timely and within plan compliance and enrollment deadlines.
  • Partner with enrollment peers to generate and validate performance KPI scorecards, reporting deliverables and audit universes. Participate in the presentation of information to customers and internal business areas.
  • Lead cross-functional performance improvement initiatives focused on quality, efficiency and customer experience and aligned with strategic objectives such as Medicaid/Medicare STARS.
  • Demonstrates a solid understanding of operational processes and controls and monitors the execution of operational changes required by regulations and guidelines associated with Medicaid Enrollment.
  • Provide guidance on delegated function oversight, including dashboard development.
  • Assist in enhancing metrics related to delegation oversight to ensure compliance with regulatory and plan requirements.
  • Serve as the subject matter expert and point of contact for state Medicaid and Medi-Cal agencies.
  • Conduct routine regulatory review and document preparation (i.e., state licensure, regulatory notification letters, ownership disclosure charts).
  • Ensure all records and files are securely maintained and confidential information is handled with utmost discretion in compliance with legal department policies.
  • Create and document process flows, functional and technical requirements in user stories, process maps for user experience design, testing and implementation.
  • Accountability for the delivery of key client professional services projects, ensuring projects are effectively delivered on-time projects and to customer expectations. Lead large projects/ programs as needed and delivery ensuring all stakeholders understand respective roles and portfolio process best practices
  • Ensure that enrollment process improvement work is conducted in compliance with standard processes, policies and procedures and meets mutually agreed upon success criteria and project timeline metrics.


Preferred

  • Excellent interpersonal and communication skills to deal effectively with all necessary levels within and outside the organization.
  • Demonstrates analytical and innovative excellence for current state and future state challenges at both the strategic and tactical level.
  • Strong organizational skills and superior attention to detail. Strong decision maker.
  • Ability to review documents for accuracy, completeness, and compliance; compile data and information for reports; compose letters and memoranda.
  • Ability to gather and research data (i.e., statutes, regulations, articles).


Note: Applicants for employment in the U.S. must possess work authorization which does not require sponsorship by the employer for a visa (H1B or otherwise).

Apply for this job now

Details

  • Job Reference: 462784223-2
  • Date Posted: 2 January 2022
  • Recruiter: Infosys BPM
  • Location: Phoenix, Arizona
  • Salary: On Application
  • Sector: Insurance & Superannuation
  • Job Type: Permanent