Manager, Enrollment & Billing

Manager, Enrollment & Billing Healthfirst is responsible for overseeing a defined line of business at Healthfirst. The incumbent will participate in developing and implementing operating policies and procedures related to enrollment, billing, reconciliation, audits, special projects, and back‑up support of other lines of business. This role focuses on monitoring operational efficiency, accuracy, documentation, and reporting quality outcomes, and providing solutions that address them. He/she will work cross‑functionally with IT and Finance to ensure processes are executed timely and accurately, and will ultimately ensure the integrity of enrollment and payment data by implementing processes that compare state sources of enrollment information (834, roster, etc.) to the core enrollment and eligibility system. Responsibilities Implements and communicates departmental standards Manages employee performance and the quality of the team’s work Monitors productivity reports and department report card Manages and develops Team Leads to be effective leaders Works with Team Leads to establish and implement departmental goals, review goals on a monthly basis, and implement a Plan of Action where goals are not met Ensures Team Leads are managing their team’s performance through coaching, feedback, documentation, and escalation to Human Resources where appropriate Engages with other operational units to ensure excellence in customer service and operational excellence Partners with direct reports to resolve problems through root cause analysis and the identification and implementation of short‑term and long‑term solutions to the problems Reconciles Account Receivable variances for Medicare Reviews document retention procedures Communicates General Ledger vs. supportable variances to Finance Corp. Additional duties as assigned Minimum Qualifications Leadership experience in a high‑volume production billing, enrollment, claims, call center environment or related environment Background in providing customer service or improving the member’s experience while addressing customer issues and complaints in a timely manner Direct supervisory or management experience in an operational department within the healthcare industry (commercial insurance plan, hospital, nursing home, third‑party administrators, or other related area) Experience managing inventories, overseeing performance management (production‑based metrics), and staff development of assigned personnel Understanding of member billing or enrollment processes to optimize and streamline current processes effectively (as needed) Experience addressing, documenting, managing employee relation issues (e.g., attendance, tardiness, or behavioral concerns) and fostering positive employee relations Experience providing project direction, supporting training and development, administering company policies Strong communication and presentation skills through all levels Bachelor’s degree from an accredited institution or relevant work experience Preferred Qualifications Experience with employee performance management systems Experience with User Acceptance Testing, Data Analysis/Reporting, and defining Business Requirements Ability to effectively work cross‑division for successful outcomes Familiarity with HIPAA 834 Specifications and/or other electronic transmission of data Sense of urgency in problem resolution and management Ability to oversee the implementation of projects and effectively communicate outcomes with all levels of staff Keeps up to date with healthcare practices, laws, regulations, and trends through participation in professional development activities Compensation & Benefits Hiring Range*: Greater New York City Area (NY, NJ, CT residents): $81,100 - $117,470 . All Other Locations (within approved locations): $71,600 - $106,505 . In addition to your salary, Healthfirst offers employees a full range of benefits such as medical, dental, and vision coverage, incentive and recognition programs, life insurance, and 401(k) contributions (all benefits are subject to eligibility requirements). Equal Opportunity Employer WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected federal, state, province or local status unrelated to the performance of the work involved. If you have a disability under the Americans with Disabilities Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to View email address on click.appcast.io or calling View phone number on click.appcast.io. In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e‑mail address and phone number supplied. #J-18808-Ljbffr Healthfirst