Virginia Premier Health Plan, Inc.

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Sr. Manager, Medicaid Enrollment

Sr. Manager, Medicaid Enrollment

Job Locations 
US-VA-Glen Allen
Job ID 
2017-4353

Job Description

Overview

The Sr. Manager, Medicaid Enrollment is responsible for the direct administrative and supervisory activities for all Enrollment functions for Medicaid line of business.  The position will promote the integration of various operational systems within the organization which support enrollment functions. Incumbent will facilitate successful outcomes by positioning resources appropriately and ensure that all personnel are properly trained. Finally, the incumbent will operate under the direct supervision of the Director, Medicaid Enrollment in areas of the Health Plan’s activities in carrying out the business plan.

Responsibilities

  • Provide direct supervision and guidance to the Enrollment Team
  • Implement strategic direction set for Enrollment activities
  • Ensure the proper loading and data validation of all enrollment related files to include, but not limited to the 834 and 820 payment files
  • Ensure that Enrollment external vendor files are sent to external vendors, loaded and validated in a timely manner
  • Demonstrate comprehensive understanding of DMAS Enrollment contractual requirements
  • Ensure that enrollment related member materials are mailed in the timeframes outlined by DMAS.
  • Develop an expertise on all enrollment related platforms to include IDX and QNXT.
  • Direct, oversee requests, and insure proper testing of system and vendor file changes for the enrollment sections
  • Identify and implement cost management strategies and process improvement initiatives
  • Ensure the proper training of all Enrollment team members
  • Develop, analyze and distribute enrollment reports
  • Develop metrics to verify outcomes and improve operations
  • Oversee and manage enrollment related projects as assigned
  • Perform other managerial duties as required.

Qualifications

MINIMUM EDUCATION REQUIREMENTS

  • Bachelor’s degree in Health Services, Business Administration or related field, or commensurate experience in lieu of degree.

SPECIAL KNOWLEDGE AND/OR SKILLS

  • Excellent understanding of healthcare insurance markets, the HMO concept, and business operations
  • Excellent oral & written communication skills
  • Demonstrated leadership skills
  • Ability to manage multiple projects while meeting deadlines and achieving business goals
  • Ability to supervise staff and promote successful performance
  • Proven ability to analyze data
  • Proven ability to work independently while managing multiple tasks and deadlines
  • Experience in use of information system resources
  • Candidate will be proficient with data analysis or business analysis in a health care environment
  • Healthcare Enrollment experience strongly preferred
  • Proficient with Microsoft office suite
  • Experience with SQL a plus

WORK BACKGROUND/EXPERIENCE

  • Management experience required.

PHYSICAL REQUIREMENTS

  • Physical health sufficient to meet the ergonomic standards and demands of the position.

 

About Us

Virginia Premier Health Plan, Inc. is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs.  Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater, Alexandria. Charlottesvile and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia. 

 

Equal Opportunity Employer
All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.

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