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Supervisor, Enrollment Quality Assurance

$71.7k - $103.73k

SCAN Health Plan

  • # Supervisor, Enrollment Quality AssuranceApplylocations: Long Beach Office 3800: Long Beach, CAtime type: Full timeposted on: Posted Todayjob requisition id: JR3199Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do.Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults.Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity.At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve.**The Job**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.**You Will*** 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.).* We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.* Actively support the achievement of **SCAN’s** Vision and Goals.* Other duties as assigned.**Your Qualifications*** 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.* Experience in Medicare Advantage is highly preferred.* 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.**What's in it for you?*** Base salary range: $71,700 to $103,732 per year* Internal title: Sup Recon & Ops* Work Mode: Mostly Onsite* 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!We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!
  • J-18808-Ljbffr SCAN Health Plan

Vacancy posted 3 days ago
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