Vice President, Enrollment and Eligibility

About the Role

The Vice President of Enrollment and Eligibility is responsible for providing strategic direction and management of the Enrollment and Eligibility Department. The VP will be a highly motivated leader with a demonstrated track record of success meeting or exceeding established objectives, leveraging a high‑performance team. The VP will be expected to ensure the department’s adherence to all existing processes and procedures while also identifying areas for efficiency and enhancement. The VP will oversee and monitor all performance‑related metrics, identify additional metrics necessary to drive accuracy and efficiency, and ensure that all enrollment and eligibility transactions and requirements meet or exceed established service‑level agreements. The VP will also serve as the point of contact for external facing customers, overseeing a service team that acts as the day‑to‑day point of contact to external clients whose eligibility the department manages.

Primary Responsibilities

• Serve as the overall subject matter expert within the company for the Enrollment and Eligibility responsibility.
• Establish department objectives that support company goals and produce regular status reports.
• Prepare an operating budget that reflects the forecasted needs of the department and control expenditures to assure adherence to approved budgets.
• Ensure effective workflows, maximize system efficiencies, monitor quality performance measures and confirm appropriate completion of work assignments. Make recommendations for change as appropriate.
• Implement checks and balances where appropriate to drive accuracy and timeliness of the Enrollment and Eligibility process.
• Ensure all departmental deliverables and reporting requirements are met within the required timeframes.
• As the leader of the Eligibility and Enrollment Department, serve as the point person with leaders from dependent departments to drive cross‑departmental collaboration.
• Partner with the technology department to drive innovation and efficiency in the Enrollment and Eligibility process, delivering high satisfaction to clients and their members.
• Approve personnel actions such as hiring, disciplinary action, termination and/or salary recommendations.
• Participate in training, coaching and motivation of employees including career path development; assess individual employee performance and conduct timely performance appraisals.
• Promote teamwork, discussion, and cooperation among staff and other departments; ensure timely communication and sharing of information with team members.
• Work with staff to resolve work‑related issues and concerns; promote a respectful and diverse workplace.
• Develop and maintain departmental policies and procedures.

Minimum Education & Qualifications

• 10+ years in the health insurance industry.
• 5+ years of management experience.
• Bachelor’s degree in Business or a Health Insurance related field.

Preferred Qualifications

• Master’s in Business Administration or a Health Insurance related field.
• Experience working with Taft‑Hartley trusts.
• Experience with self‑funded insurance plan administration.
• Familiarity with ERISA rules and regulations.
• Experience overseeing Enrollment and Eligibility Responsibilities or a plan or self‑administered group.
• Preferred residence near Westbury, NY office, but not required.