Medicare & Medicaid Enrollment Supervisor

Overview

Are you a Medicare & Medicaid Enrollment Leader looking to work for an amazing organization by serving others and connecting with your co-workers?

Immanuel Pathways PACE® is seeking an
Enrollment & Eligibility Supervisor to work at Immanuel Home Office located at 1044 North 115th Street, Omaha, NE 68154.

This leadership role is responsible for overseeing Medicare enrollment, Medicaid eligibility, participant enrollment processes, regulatory compliance, enrollment reconciliations, and benefit administration across multiple PACE centers. The position also supervises eligibility staff, develops quality assurance processes, and partners with operational leaders to ensure enrollment accuracy and exceptional participant service.

Pay will be based upon experience, certifications, skills and education.

Best in Class Benefits can be found at Immanuel:

• HEALTH
  :
  Medical, dental, vision, Health Savings Account (HSA), and Flexible Spending Account (FSA)
• LIFE INSURANCE
  :
  Employer Paid Life Insurance
• TIME OFF
  :
  Paid Time Off - accruing from day one of employment, Floating Holidays, Paid Holidays, 8 hours of Volunteer Time Off per year
• RETIREMENT
  : 401K with employer match
• WELLNESS
  :
  Wellness Program and Employee Assistance Program
• GROWTH AND DEVELOPMENT
  :
  Advancement opportunities (as appropriate) – we look to grow from within our organization, Education Assistance Program – we invest up to $5,250 per year for education assistance paid up front
• Plus many more benefits!

What You Will Do

The purpose of this job is to provide oversight of Medicare and Medicaid enrollment, participant eligibility, and benefit administration activities across all PACE centers. The Enrollment & Eligibility Supervisor will ensure that participant enrollment information is complete, accurate, timely, and consistent across organizational systems, state Medicaid systems, and Centers for Medicare & Medicaid Services (CMS) enrollment systems.

Skills & Requirements

Education-

• Bachelor’s degree in healthcare administration, business administration, finance, or a related field is preferred.
• Equivalent combination of education or years of relevant experience may substitute for education requirement.

Experience-

• Three (3) years of progressively responsible experience in Medicare, Medicaid, PACE, managed care, health plan operations, enrollment, eligibility, or revenue cycle preferred.
• Previous supervisory or leadership experience preferred.
• One (1) year of experience working with the frail or elderly population required, or completion of job specific training related to working with the elderly population must be completed within the first six months of hire

Key (Essential) Functions of this Job

Enrollment Oversight

• Provide centralized oversight of PACE enrollment documentation and eligibility processes across all PACE centers.
• Establish standardized processes and controls to ensure required Medicare, Medicaid, demographic, payer, and eligibility information is accurately collected and documented prior to participant enrollment.
• Review enrollment documentation and conduct routine audits to ensure required information is complete, accurate, and consistent across enrollment paperwork and organizational systems.
• Partner with center Enrollment Coordinators, Program Relationship Managers, Executive Directors and other leaders to resolve enrollment documentation deficiencies or discrepancies.
• Ensure Medicare Beneficiary Identifier information, Medicaid identification information, Medicare entitlement status, Medicaid eligibility status, payer information, and other required enrollment information are accurately entered into applicable systems.
• Develop enrollment checklists, quality assurance processes, and standardized workflows for use across all PACE centers.
• Provide training and ongoing education to enrollment staff regarding Medicare and Medicaid documentation requirements.
• Identify trends in enrollment errors and implement process improvements to reduce recurring issues.

Medicare Enrollment & CMS Reconciliation

• Oversee monthly Medicare enrollment and disenrollment processes.
• Review CMS transaction reports, including the Daily Transaction…