Document Control Specialist

Enrollment And Provider Data Management LeadershipProvides leadership, strategic direction, and operational oversight for Enrollment and Provider Data Management functions across all health plan lines of business, including Commercial, Medicare, Medicaid, and other health plan products. Responsible for ensuring accurate and timely member enrollment, eligibility maintenance, provider data management, provider directory accuracy, and regulatory compliance. Leads operational teams, develops business processes, monitors performance metrics, and collaborates with internal and external stakeholders to support organizational goals, regulatory requirements, operational excellence, and exceptional customer and provider experiences.Bachelor's degree in healthcare administration, Business Administration, Information Systems, Public Health, or a related field; or equivalent combination of education and experience required.Five (5) years transitional operations experience in health plan operations required.Three (3) years of leadership experience required.Experience in the following preferred:Medicare Advantage, Medicaid, and Commercial health plan operations.Managing regulatory compliance, audits, and operational reporting.Enrollment platforms, provider data systems, claims systems, and healthcare technology applications.Project management, process improvement, or Lean practices.Leadership - Inspires, motivates, and guides others toward accomplishing goals. Achieves desired results through effective people management.Conflict resolution - Influences others to build consensus and gain cooperation. Proactively resolves conflicts in a positive and constructive manner.Critical thinking – Identifies complex problems. Involves key parties, gathers pertinent data and considers various options in decision making process. Develops, evaluates and implements effective solutions.Communication and team building – Leads effectively with excellent verbal and written communication. Delegates and initiates/manages cross-functional teams and multi-disciplinary projects.Advanced knowledge of health plan enrollment, eligibility, provider data management, and healthcare operations. Knowledge of Medicare, Medicaid, Commercial, CMS, and State regulatory requirements.Ability to develop and monitor operational metrics and performance standards.Advanced proficiency with Microsoft Office applications and healthcare operational systems.