The Enrollment & Eligibility Supervisor directly supervises enrollment, eligibility and benefit plan analysts and carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Is responsible for a higher-level knowledge in the analysis and management of day to day operations and team progress of enrollment and eligibility files, as well as benefit plan coordination. Will support team members and management in creating and analyzing work flows for efficiency and quality.
Duties and Responsibilities:
- Responsible for supervising the overall quality of enrollment, eligibility and benefit plan processes as they pertain to departmental policies and procedures as well as compliance and Health Plan and contractual obligations.
- Provides training support for new employees and existing enrollment, eligibility and benefit plan analysts on policies and procedures and regulatory guidelines in accordance Health plan and contractual agreements.
- Provides general enrollment, eligibility and benefit plans support to teams in reviewing, resolving, member inquiries specific to eligibility to acquire authorized services, as well as the coordination of the member’s benefits, as provided by the Health Plans.
- Responsible to process and respond to Health Plan inquiries and coordinates with appropriate departments for any provider, member, or system issues.
- Responsible for recommending changes in guidelines, procedures, and policies. Ensuring the use of the best standard process workflows and operational excellence in activities.
Education:
High school diploma/GED required. Bachelor's degree in Healthcare or related field preferred.
Experience:
Two (2) years of supervisory experience in health plan payer enrollment or related field required.
Cedars-Sinai is a leader in providing high-quality healthcare encompassing primary care, specialized medicine and research. Since 1902, Cedars-Sinai has evolved to meet the needs of one of the most diverse regions in the nation, setting standards in quality and innovative patient care, research, teaching and community service. Today, Cedars- Sinai is known for its national leadership in transforming healthcare for the benefit of patients. Cedars-Sinai impacts the future of healthcare by developing new approaches to treatment and educating tomorrow's health professionals. Additionally, Cedars-Sinai demonstrates a commitment to the community through programs that improve the health of its most vulnerable residents.
With a growing number of primary urgent and specialty care locations across Southern California, Cedars-Sinai’s medical network serves people near where they live. Delivering coordinated, compassionate healthcare you can join our network of clinicians and physicians to improve the healthcare people throughout Los Angeles and beyond.
Req ID : 11749
Working Title : Supervisor, Enrollment & Eligibility - Managed Care
Department : MNS Managed Care
Business Entity : Cedars-Sinai Medical Center
Job Category : Strategic Plan / Business Dev
Job Specialty : Managed Care
Overtime Status : EXEMPT
Primary Shift : Day
Shift Duration : 8 hour
Base Pay : $42.16 - $65.35
