Supervisor, Enrollment and Quality Assurance - Kelsey Seybold Clinic - Pearland Business Office 2368367 | Pearland, TX | Kelsey-Seybold Clinic

Explore Opportunities With Kelsey-Seybold Clinic

Work with one of the nation's leading health care organizations and build your career at one of our 40+ locations throughout Houston. Be part of a team that is nationally recognized for delivering coordinated and accountable care. As a multi-specialty clinic, we offer care from more than 900 medical providers in 65 medical specialties. Take on a rewarding opportunity to help drive higher quality, higher patient satisfaction and lower total costs. Join us and discover the meaning behind Caring. Connecting. Growing together.

Primary Responsibilities

• This position supervises Enrollment Analysts, Billing Coordinator, Coordination of Benefits Analyst and/or Team Leads for Medicare Advantage and Commercial Plans, managing daily assignments, productivity, and CMS file processing
• The Supervisor resolves enrollment and eligibility discrepancies, reviews transaction reports, and ensures accurate and timely processing per CMS guidelines, including correspondence to Medicare Advantage members
• The role oversees the various team, acting as a liaison between staff and management to maintain system integrity, analyze workflows, and keep processes and training up to date
• Additionally, the Supervisor manages the departmental quality and supports process improvements and workflow optimization for productivity
• This position assists with Enrollment projects and serves as a backup to the Manager as needed

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications

• High School Diploma or equivalent
• 3+ years of experience with Enrollment/Eligibility or in a MA Healthcare Environment
• 3+ years of experience as a supervisor/team lead or demonstrated proficiency as an Enrollment Specialist or Subject Matter Expert
• Ability to read and interpret technical reports
• Ability to understand databases including importing and exporting of data
• Proficient with various applications to include: Excel, Access, Word, Visio and Internet Explorer
• Ability to communicate technical concepts to technical and non-technical people
• Excellent written and verbal communication skills
• Be flexible, able to work overtime as needed
• Detail oriented, and work with minimum supervision to meet strict regulatory guidelines
• Solid organizational skills

Preferred Qualifications

• 3+ years of experience ASO Commercial Products/Managed Care
• 1+ years of Quality Assurance experience
• 1+ years of Trizetto system software experience
• Experience with EPIC CRM
• Experience CMS MARx system

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary for this role will range from $49,700 - $88,800 annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

OptumCare is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.