Enrollment Team Lead

This is a fully remote position, open to applicants in United States.

📋 Description

• Report directly to the Enrollment Manager.

• Support essential processes to ensure the Enrollment Operations Business Unit runs smoothly.

• Assist in supervising both onshore and offshore enrollment specialists.

• Manage and address discrepancy queues, RPC, LEP, briefcases, and JIRA tickets.

• Provide assistance during audits.

• Oversee the submission of correspondence.

• Generate reports for clients.

• Maintain inboxes and assign tasks accordingly.

• Interpret regulations and directives according to the CMS Manual System and guidelines from other regulatory agencies.

• Aid in the development and review of policies and procedures for compliance with CMS standards.

• Research, analyze, and distribute CMS guidance and communications.

• Collaborate with business units to enhance workflows and business processes.

• Suggest continuous improvements to core processes and contribute to positive SLA outcomes.

• Address inquiries and provide information, coaching, and training to both onshore and offshore personnel.

• Draft and maintain documentation related to Enrollment's internal operations.

• Act as a Lead Enrollment Subject Matter Expert (SME).

⛳️ Requirements

• Minimum of 7 years of experience in a relevant field, typically spanning two subject areas.

• Comprehensive understanding of Medicare Advantage products.

• Familiarity with CMS transaction files and enrollment-related directives.

• Experience with CMS interfaces and systems related to Medicare Advantage enrollment and billing.

• Capability to analyze enrollment reconciliation data.

• Skill in reporting SLAs, KPIs, and other operational reports, and presenting findings in an organized manner.

• Bachelor’s degree in a related field; a relevant combination of education and experience may be accepted in lieu of a degree.

• Proficiency in current industry-standard PC applications and systems, including Access, Excel, Word, and PowerPoint.

• Eagerness to learn.

• Ability to collaborate effectively within a team.

• Significant creativity and adaptability.

• Strong work ethic.

• Capability to work across multiple time zones in a hybrid or remote work setting.

• Completion of a pre-employment criminal background check may be required.

🏝️ Benefits

• Opportunity for a remote work environment.

• Flexible hybrid or remote work options.

• Potential travel may be required based on company needs.

• Reasonable accommodations available for individuals with disabilities.

• Equal opportunity employer dedicated to workforce diversity.