Enrollment & Eligibility Manager

Enrollment & Eligibility Manager

This position is national remote. You'll enjoy the flexibility to telecommute
* from anywhere within the U.S. as you take on some tough challenges. For all hires in Minneapolis, Virginia, Maryland, or Washington, D.C. area, you will be required to work in the office for a minimum of four (4) days per week.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities.

Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Enrollment & Eligibility Manager will be responsible to oversee day to day activities related to enrollment and eligibility operations in order to accomplish the business and their team's objectives. Our Manager's and their teams have a serious responsibility to make every contact informative, productive, positive, and memorable.

This position is full-time (40 hours/week) Monday
- Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm local time zone. It may be necessary, given the business need, to work occasional overtime.

We offer weeks of on-the-job training. The hours of training will be aligned with your schedule.

Primary Responsibilities:

• Supervise Eligibility Supervisor's and Representatives in their daily job functions to ensure files are applied timely and all turnaround times and quality standards are met and/or exceeded
• Meet and exceed department quality audits and provide coaching to their supervisor's and team members
• Maintain and prioritize eligibility discrepancies, analyzing transactional data & submitting retroactive eligibility changes to the director and senior leaders
• Monitoring eligibility reconciliation based on received capitation and monthly variance reports
• Handle all escalations courteously, politely and professionally
• Act as back-up support for other Managers as needed for meetings and other departmental responsibilities
• Advise management in long-range planning for areas of specialization
• Perform other duties as assigned
• Managing team productivity, time cards, and attendance reporting
• Handle risk identification and perform root-cause analysis
• Conduct monthly reporting for team and departmental status updates/briefings
• Monitoring inventory & capacity reports and workload volumes for identification of needs for capacity planning and/or cross-coverage within the department
• Inter-departmental collaboration with other core operations teams

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

• High School Diploma / GED or equivalent work experience
• Must be 18 years of age or older
• 3+ years of billing and/or eligibility experience
• 3+ years of Management or Supervisory experience to include experience with managing direct reports
• Proficiency with computer and Windows PC applications
• Intermediate level experience using Microsoft Excel & Power Point
• Ability to work full-time (40 hours/week) Monday
  - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm local time zone. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

• Experience with EPIC OR EZCap
• Experience with Eligibility Manager
• Experience with FACETS
• Interpersonal skills
• Ability for oral and written communication skills
• Must have the ability to handle multiple issues and prioritize appropriately while working swiftly & efficiently without compromising quality customer service
• Organizational skills with the ability to…