Enrollment Director-Health Plan

Location: Rancho Cardova, CA
Date Posted: 11-19-2017
Position Purpose: Provide strategic direction for all enrollment functions by providing technical and leadership support. Oversee enrollment functions to ensure that all efforts are parallel with the mission and objectives of the plan.
  • Oversee the Eligibility and Enrollment department staff
  • Establish working relationships with external sources with Health & Human Services Commission (HHSC), state enrollment broker and other local state offices
  • Collaborate with internal operations teams to identify efficient solutions to meet business needs related to enrollment and facilitate continued process improvement
  • Establish and maintain liaison relationships with corporate IT to support and facilitate the common goals and objectives related to enrollment and eligibility services
  • Design and test new codes sets and processes for new product implementation to include business rule integration and state contract compliance
  • Manage and establish file interchanges with external vendors and affiliates including the mailhouse
  • Direct resolution to state complaint trends related to enrollment and eligibility
  • Represent the health plan in state MIS meetings
  • Develop and implement a reconciliation process of enrollment and financial records
  • Direct the eligibility load process while coordinating with corporate IS department to resolve issues that arise during the process
  • Coordinate monthly reconciliation process of remittance files by resolving discrepancies in the report
Education/Experience: Bachelor's’ degree in related field or equivalent experience. 7+ years of managed care or government programs preferred. Previous management experience including responsibilities for hiring, training, assigning work and managing performance of staff.
Very competitive salary and benefits!
Great company to work for!
Full relocation package is available!
Don't miss out! Apply now and we'll be in touch immediately with more specific details, salary information and to answer any questions!!

This position does NOT provide sponsorship so please do NOT apply if you require sponsorship.  Thank You

KP Recruiting Group 
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KP Recruiting Group is a well established and very respected recruiting firm.  We have built a strong reputation as a premier resource for providing highly qualified candidates for our clients.  We are very experienced in many industries and have a wide range of clients.  We will serve as your advocate during your career search!  Let us do the work for you!  There is never a fee for our services!

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