Manager, Membership & Eligibility- Hybrid

Overview

Manages the day to day operations of the VNS Health Plans Membership and Eligibility Unit (MEU) functions related to enrollment and disenrollment activities, member premium billing / collections, and prescription drug event reconciliation activities for all VNS Health Plans Medicare product lines and the Fully Integrated Dual Advantage (FIDA) plan. Supervises Third Party Administrator (TPA) Enrollment / Reconciliation / Billing entities and Third Party vendors to ensure smooth transitions of data transfers. Monitors enrollment processing activities to ensure compliance to Center for Medicare and Medicaid Services (CMS) and State Department of Health (SDOH) guidelines and plan\'s enrollment contractual agreements.

Develops and implements internal control procedures to ensure efficient performance of all membership and eligibility functions. Works under general direction.

What We Provide

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life Disability
• Employer-matched retirement saving funds
• Personal and financial wellness programs
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities

What You Will Do

Qualifications

Education :

Bachelor\'s Degree in Business Administration, Health Administration, or related discipline required; Master\'s Degree in Business Administration or Health Administration preferred.

Work Experience :

Minimum five years direct supervision and management of staff, preferably in a health care environment required. Demonstrated knowledge of enrollment operations, with strong knowledge of Medicare and working knowledge of Medicaid. Has understanding of an effective and efficient reconciliation system and some knowledge of financial operations. Advanced proficiency with Excel, Access and Word software applications required. Effective oral, written and interpersonal communication skills required.

Pay Range

USD $93,400.00 - USD $116,800.00 / Yr.

About Us

VNS Health is one of the nation\'s largest nonprofit home and community-based health care organizations. Innovating in health care for more than 130 years, our commitment to health and well-being is what drives us - we help people live, age and heal where they feel most comfortable, in their own homes, connected to their family and community. On any given day, more than 10,000 VNS Health team members deliver compassionate care, unparalleled expertise and 24 / 7 solutions and resources to the more than 43,000 \"neighbors\" who look to us for care. Powered and informed by data analytics that are unmatched in the home and community-health industry, VNS Health offers a full range of health care services, solutions and health plans designed to simplify the health care experience and meet the diverse and complex needs of the communities and people we serve in New York and beyond.

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