Director, Health Plan Enrollment & Eligibility
Tasks
- Conduct audit readiness
- Coordinate Medicare and Medicaid
- Design enrollment workflows
- Establish operational controls
- Govern departmental policies
- Handle member communications
- Identify operational risk
- Lead corrective actions
- Manage eligibility operations
- Manage membership data integrity
- Monitor enrollment accuracy
- Oversee CMS interactions
- Oversee Medicaid reeligibility
- Own census integrity
- Own member coverage continuity
- Resolve enrollment and eligibility issues
- Run KPI performance management
Perks/Benefits
Skills/Tech-stack
Audit Readiness | Capitated Healthcare | Census Management | Eligibility | Enrollment | KPI Reporting | Medicaid | Medicaid Reeligibility | Medicare | Medicare Medicaid Coordination | Medicare/Medicaid | Microsoft Excel | Microsoft PowerPoint | Microsoft Word | Operational Controls | Risk Management
Education
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