Description and Requirements

The Manager, Enrollment & Billing is responsible for overseeing a defined line of business at Healthfirst. The incumbent will be responsible for participating in the development and implementation of operating policies & procedures which may include: enrollment; billing; reconciliation, audits, special projects, and back up support of other lines of business as needed or required. The role focuses on monitoring operational efficiency, accuracy, documentation and reporting quality outcomes and providing solutions that address the outcomes. In addition the Manager, Enrollment & Billing ensures deadlines are met and the life cycle of project implementation is executed timely and accurately. He/she will work cross-functionally with IT and Finance to ensure that processes are executed timely and accurately. This role is ultimately responsible to ensure the integrity of enrollment and payment data by implementing processes that compare state sources of enrollment information (834, roster, etc.) to our core enrollment and eligibility system to ensure that all enrollment and disenrollment activity is captured accurately and that Healthfirst is appropriately paid by the state and subscribers. The role is responsible for monitoring employee performance and implementing improvement solutions as well as hiring new staff and overseeing all appropriate training. A Manager at Healthfirst functions as an advisor to a department, function, or organizational unit regarding duties, responsibilities, projects and/or activities. He/she is actively involved in daily operations only when required to meet schedules or resolve problems. His/her primary role is to implement and execute policies and to ensure that departmental priorities, schedules and deliverables are attained. This level typically has responsibility for achieving budget targets, planning, scheduling and procedural changes.

• Leadership experience in a high volume production billing, enrollment, claims, call center environment or related environment.
• Background in providing customer service or improving the member's experience while addressing customer issues and complaints in a timely manner.
• Direct supervisory or management experience in an operational department within the healthcare industry (which can include commercial insurance plan, hospital, nursing home, third party administrators, or other related area).
• Experience managing inventories, overseeing performance management (production based metrics) and staff development of assigned personnel.
• Understanding of member billing or enrollment processes in order to optimize and streamline current processes effectively (as needed).
• Experience addressing, documenting, managing employee relation issues (i.e. attendance, tardiness, or behavioral concerns) and fostering positive employee relations.
• Experience providing project direction, supporting training and development, administering company policies.
• Strong communication and presentation skills through all levels.
• Bachelor's degree from an accredited institution

• Any experience with employee performance management systems.
• Experience with User Acceptance Testing, Data Analysis/Reporting and defining Business Requirements.
• Demonstrate the ability to effectively work cross-division for successful outcomes.
• Familiar with the HIPAA 834 Specifications and/or other electronic transmission of data.
• Demonstrate a sense of urgency in problem resolution and management.
• Can oversee the implementation of projects and effectively communicate outcomes with all level staff.
• Keeps up to date with healthcare practices, laws regulations and trends through participation in professional development activities.