Enrollment Services Manager

Location:

Hybrid (Onsite Tuesday, Wednesday, Thursday) – Must reside in Pennsylvania, New Jersey, or Delaware

About the Role

We are seeking a Manager, Enrollment Services to lead and optimize enrollment operations across multiple lines of business, including Medicare Advantage, Medigap, and ACA Individual market

s.In this role, you will oversee the accurate, timely, and compliant processing of enrollment transactions across internal platforms and external vendor systems. You will lead a team of analysts and system support professionals while driving operational excellence, regulatory compliance, and continuous improvement initiatives.

What You’ll

Lead and manage a team of Business Analysts and Business Systems Support Administrators Foster a collaborative, high-performing team culture focused on accountability and continuous improvement. Support hiring, training, and development of team members. Represent the Director in meetings and decision-making forums when needed

Enrollment Operations & Compliance

Ensure accurate and timely processing of enrollment transactions across Medicare Advantage, Medigap, ACA, and EDI channels. Oversee reconciliation of Medicare Advantage enrollment data with CMS and internal systems. Ensure compliance with federal and state regulations, reporting requirements, and operational po

licies. Act as the primary point of contact for Government Markets reconciliation processes. Lead readiness and coordination for regulatory audits (CMS, PID,DOBI)

Data, Reporting & Analysis

Analyze operational metrics to assess performance, efficiency, and compliance. Oversee submission of required regulatory reports accurately and

on time. Conduct audits including EDI transactions and Member t. Present enrollment metrics and reconciliation results to senior leadership, including CMS attestation meetings

Cross-Functional Collaboration Partner with teams across Operations, IT, Compliance, Regulatory, and Customer Service implementation of regulatory or system-driven process changes.

Facilitate recurring meetings to review audit findings, analytics, and operational improvements

Improvement

Develop and maintain Enrollment Services policies and procedures. Support the Director in setting strategic direction and operational priorities. Identify opportunities to enhance workflows, improve efficiency, and strengthen compliance

Minimum Qualifications

5+ years of experience in health plan enrollment or operational environments3+ years of people leadership experience. Strong understanding of enrollment workflows, operational processes, and data systems. Experience with regulatory compliance and enrollment reporting.

Proven ability to lead cross-functional initiatives. Strong analytical, organizational, and communication skills.

Proficiency in Microsoft Office (Excel, Word, PowerPoint; Visio and SharePoint preferred)

Preferred Qualifications

Experience with Medicare Advantage and Commercial enrollment regulations. Familiarity with tools such as Advantasure, Health Proof, Zelis, EDI portals, and telephony systems (e.g., Avaya)
Experience in policy development and regulator

y audit management. Ability to translate complex regulatory requirements into operational processes

Additional Requirements

Must reside in PA, NJ, or DE. Must be able to work onsite Tuesday, Wednesday, and Thursday. Must have access to an Android or iOS device compatible with Microsoft Authenticator

What Success Looks Like

Accurate and compliant enrollment processing across all channels. Strong audit readiness and successful regulatory outcomes

High-performing and engaged team Improved operational efficiency and effective cross-functional collaboration

Equal Opportunity Employer Statement

We are an equal opportunity employer and are committed to building a diverse and inclusive workforce. We do not discriminate on the basis of race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, veteran status, genetic information, or any other legally

protected characteristic. We encourage individuals from all backgrounds to apply and are dedicated to providing an inclusive workplace