Eligibility​/Enrollment Manager

Responsibilities

• Oversee and supervise enrollment staff, evaluate staff’s achievement of performance standards, productivity, and attendance in accordance with established departmental and Human Resources guidelines and Collective Bargaining Agreement (CBA); identify areas for development, create improvement plans, coach and counsel staff as appropriate
• Develop and Maintain Standard Operating Procedures and appropriate protocols
• Create weekly and monthly staff production reports on Microsoft Excel; analyze data and review statistics of member service inquiries
• Conduct staff training and development according to enrollment and eligibility operating procedures and protocols
• Resolve complex enrollment and eligibility inquiries via telephone, in writing, or in person in a confidential manner; assist members and Fund staff with various eligibility issues
• Review and validate daily Executive Lives report to ensure continuity in health benefits
• Collaborate with Pension Department (DWF’s, bank, valuation reports etc.)
• Assist and Support Senior Manager with Code Blue enrollment/eligibility reporting and reconciliation process and ordering of Health  for newly organized members (new institutions and new units)
• Assist and support Vitech testing, data migration and review of client test specifications
• Assist and support Senior Manager in ensuring department goals and Fund objectives are implemented, accurately communicated and achieved
• Assist and support Senior Manager in reviewing and validating Job Security Fund quarterly true-up reports and inquiries
• Provide back up support for Eligibility Staff Coordinator
• Perform additional duties and special projects as assigned by management

• Bachelor’s degree in health administration, Business Management or equivalent years of experience required
• Minimum of five (5) years eligibility experience in a health benefits environment; to include a minimum two (2) years supervisory experience required
• Knowledge of disability, managed care, coordination of benefits, and multi fund benefit plans
• Excellent knowledge of health claims processing and eligibility systems preferred (Vitech, QNXT)
• Knowledge of Pharmacy Benefit Manager programs and benefit plans and groups (CVS, Express Scripts)
• Knowledge of Microsoft Excel and Word
• Good leadership skills and ability to motivate staff
• Strong written and verbal communications skills necessary
• Strong time management skills and ability to multi-task
• Excellent analytical skills, problem-solving abilities; must work well under pressure
• Able to interact well with individuals at all levels; exercise good judgment and discretion while working in a confidential environment