Supervisor, Enrollment Quality Assurance

SCAN Health Plan • Long Beach, CA

1d • Onsite

About The Position

The Supervisor, Enrollment Quality Assurance (QA) is responsible for the day-to-day supervision of the enrollment reconciliation and operations specialist staff and the activities related to Medicare health plan members and employer groups.

Requirements

• Bachelor's or Technical Degree or equivalent experience required.
• 3+ years of experience in enrollment and reconciliation experience in the Health Care or Health Plan industry.
• Demonstrated supervisory experience.
• Leadership - Basic skills to develops others.
• Problem Solving - Basic problem solving skills.
• Communication - Good written and verbal communication and interpersonal skills.
• Microsoft Office (Word, Excel, PowerPoint, Outlook, Teams) at advanced level is required.

Nice To Haves

• Experience in Medicare Advantage is highly preferred.
• We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.

Responsibilities

• Oversee data workflows and daily enrollment reconciliation and operations specialist tasks to ensure timely and accurate outcomes
• Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, participating in professional societies.
• Monitors the work between cross-functional departments by coordinating support to Enrollment and Reconciliation (E&R) and Grievance and Appeals (GAD) departments
• Contributes to team effort by accomplishing related results as needed.
• Improves processes by evaluating existing membership and payment reconciliation data workflows and offering suggestions to Management on implementation or monitoring guidelines for software programs to ensure optimum reconciliation revenue is captured.
• Trains staff and monitors work to ensure operations are at the level necessary to meet established guidelines and regulatory requirements
• Oversees workflow, assigns work responsibilities and tasks, and prioritizes deliverables in order to meet department goals and objectives.
• Fields escalated issues and non-routine questions, providing guidance and direction to team.
• Keeps abreast of changes to legislation and regulations which pertain to health insurance procedures.
• Oversees the preparation of reports by collecting, analyzing, and summarizing information and trends; recommends courses of action to management.
• Facilitates and works with management team to fulfill audit requests as needed.
• Maintains staff job results by coaching, counseling, and disciplining employees; planning, monitoring and appraising job results.
• Supervises/Manages Others (i.e. hires, performance reviews, corrective action, etc.).
• Actively support the achievement of SCAN’s Vision and Goals.
• Other duties as assigned.

Benefits

• An annual employee bonus program
• Robust Wellness Program
• Generous paid-time-off (PTO)
• Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
• Excellent 401(k) Retirement Saving Plan with employer match and contribution
• Robust employee recognition program
• Tuition reimbursement
• An opportunity to become part of a team that makes a difference to our members and our community every day!

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: Associate degree