Manager - Former Employee Enrollment Unit

Oklahoma State Government•Oklahoma City, OK

43d•Onsite

About The Position

The Oklahoma Health Care Authority (OHCA) works to ensure Oklahomans have access to better health and better care. The agency’s core values include passion for purpose, trust and transparency, empowerment and accountability, best in class and outcome-driven, and servant leadership. As part of the interview process, candidates may be required to attend an in-person interview at our Oklahoma City office. The Former Employee Enrollment Manager oversees the enrollment processes for former employees, ensuring accuracy, compliance, and timely handling of all related forms, correspondence, and special projects. This role is vital in maintaining up-to-date procedures, supporting system operations, and ensuring compliance with federal guidelines.

Requirements

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
The key Knowledge, Skills, and Abilities (KSAs) for the Former Employee Enrollment Manager position include a deep understanding of eligibility rules for health and dental plans, proficiency in COBRA and CMS guidelines, strong leadership and organizational skills, and the ability to audit and review documents for compliance.
The Korn Ferry competencies that best correlate with this role are "Builds Effective Teams" and "Ensures Accountability," as the position involves leading a team and ensuring compliance with complex regulations.
To be considered for this position your application must include a resume/CV with complete work and education history.
A master’s degree and 2 years of professional experience ; OR A bachelor’s degree and 3 years of professional experience; An equivalent combination of education and experience, substituting one year of professional or technical administrative experience in business or public administration for each year of the required education.
NOTE: No substitution will be allowed for the required professional experience in a supervisor or administrative capacity.

Nice To Haves

A candidate that is proficient in Microsoft Office
Has managerial experience in a professional level position
Has obtained bachelor’s degree in accounting, business, finance or closely related field and two years of experience in insurance eligibility determination; the maintenance, analysis and reconciliation of insurance or benefits accounts or closely related work OR An equivalent combination of education and experience.

Responsibilities

Routinely audit work performed by staff to ensure all Medicare Part D correspondence, referrals, special projects, and required letters are handled in accordance with CMS compliance.
Oversee and audit non-Medicare work and correspondence and ensure accuracy and professionalism.
Protect the privacy and confidentiality of program participants' information in compliance with HIPAA regulations and complete all required training.
Ensure all enrollment forms, change forms, electronic files, and reject records are processed within 5 working days with 96% accuracy, adhering to all unit procedures and EGID regulations.
Lead recurring unit meetings and trainings.
Attend department/division/agency meetings and any mandatory trainings provided by the division or agency.
Manage the distribution of special projects to the unit, assist in the completion of special projects, serve on committees as requested, respond to internal and external inquiries within designated timeframes while maintaining confidentiality and compliance with EGID regulations and participate in implementation projects for the department, division and/or agency.
Lead, mentor, and develop the former employee enrollment team to ensure high performance and adherence to best practices and company policies.
Manage the distribution of incoming reports and queries for the unit to ensure work is distributed evenly and deadlines are being met.
Assign daily, weekly and monthly tasks to staff and track progress to completion.
Ensure that COBRA packets are sent, billing statements are produced, and enrollments are processed within the required Department of Labor federal timeframes.
Ensure all Medicare EGWP files are received on schedule and that all enrollments/disenrollments/changes are processed within the required timeframes and according to CMS guidance.
Other duties as assigned.