Description

A member of the Medicare Advantage Operations leadership team, the Medicare Advantage Enrollment Supervisor is responsible for leading and supervising the day-to-day enrollment operations. The ideal candidate will have experience with 834 EDI, State (CA DHS) and CMS files.

Responsibilities include but are not limited to:

• Overseeing all aspects of the Medicare Membership Enrollment, Reconciliation, and benefits coordination operations

• Represent enrollment and reconciliation operations in projects and acting as Product Owner for Enrollment and ensure requirements are implemented by the project team

• Review and approve requirements documents, participate in solution definition, provide guidance and directions to the project team, coordinate cross-functional discussions and efforts, create reports and or timelines

Salary Range: $64,800 - $137,600/AnnuallyQualifications

We're seeking detail-oriented, self-directed professional with:

• High School Diploma or equivalent experience required

• Minimum of two years' experience in a Medicare health plan or Managed Care environment supervising Member Enrollment and Billing staff and processes required

• Three years or more in CMS Medicare Managed Care and Managerial experience required

• Robust knowledge of Medicare and CMS enrollment and billing regulatory requirements

• Strong leadership skills, with the ability to articulate goals, plan and implement processes to achieve those goals, recognize and assess the implications of confounding variables, anticipate consequences, and meet deadlines

• Working knowledge of Microsoft Office Suite (Excel, Word, and PowerPoint) and data visualization tools

• Skill in prioritizing and performing a variety of duties within a system that has frequently changing assignments, priorities and deadlines

• Reliability and compliance with scheduling standards

• Ability to modify and adapt operational procedures to changing operational needs

• Ability to analyze and organize complex federal and private insurance regulations

• Ability to support the working hours of the department

• Ability to travel/attend off-site meetings and conferences

UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.