Enrollment & Eligibility Manager

Posted 3 Hours Ago
Be an Early Applicant
Dallas, TX, USA
In-Office
73K-130K Annually
Mid level
Artificial Intelligence • Big Data • Healthtech • Information Technology • Machine Learning • Software • Analytics
The Role
The Enrollment & Eligibility Manager oversees daily enrollment and eligibility operations, manages teams, ensures quality, and handles escalations while collaborating inter-departmentally.
Summary Generated by Built In
Requisition Number: 2365724
This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. For all hires in Minneapolis, Virginia, Maryland, or Washington, D.C. area, you will be required to work in the office for a minimum of four (4) days per week.
Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
The Enrollment & Eligibility Manager will be responsible to oversee day to day activities related to enrollment and eligibility operations in order to accomplish the business and their team's objectives. Our Manager's and their teams have a serious responsibility to make every contact informative, productive, positive, and memorable.
This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm local time zone. It may be necessary, given the business need, to work occasional overtime.
We offer weeks of on-the-job training. The hours of training will be aligned with your schedule.
Primary Responsibilities:
  • Supervise Eligibility Supervisor's and Representatives in their daily job functions to ensure files are applied timely and all turnaround times and quality standards are met and/or exceeded
  • Meet and exceed department quality audits and provide coaching to their supervisor's and team members
  • Maintain and prioritize eligibility discrepancies, analyzing transactional data & submitting retroactive eligibility changes to the director and senior leaders
  • Monitoring eligibility reconciliation based on received capitation and monthly variance reports
  • Handle all escalations courteously, politely and professionally
  • Act as back-up support for other Managers as needed for meetings and other departmental responsibilities
  • Advise management in long-range planning for areas of specialization
  • Perform other duties as assigned
  • Managing team productivity, time cards, and attendance reporting
  • Handle risk identification and perform root-cause analysis
  • Conduct monthly reporting for team and departmental status updates/briefings
  • Monitoring inventory & capacity reports and workload volumes for identification of needs for capacity planning and/or cross-coverage within the department
  • Inter-departmental collaboration with other core operations teams

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 / GED or equivalent work experience
  • Must be 18 years of age or older
  • 3+ years of billing and/or eligibility experience
  • 3+ years of Management or Supervisory experience to include experience with managing direct reports
  • Proficiency with computer and Windows PC applications
  • Intermediate level experience using Microsoft Excel & PowerPoint
  • Ability to work full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm local time zone. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:
  • Experience with EPIC OR EZCap
  • Experience with Eligibility Manager
  • Experience with FACETS
  • Interpersonal skills
  • Ability for oral and written communication skills
  • Must have the ability to handle multiple issues and prioritize appropriately while working swiftly & efficiently without compromising quality customer service
  • Organizational skills with the ability to prioritize caseload based on business and customer need as well as respond appropriately and effectively in difficult situations
  • Knowledge of Human Resources policies and procedures

Telecommuting Requirements:
  • Ability to keep all company sensitive documents secure (if applicable)
  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy
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). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.
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.
UnitedHealth Group 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.
UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.

Skills Required

  • High School Diploma / GED or equivalent work experience
  • 3+ years of billing and/or eligibility experience
  • 3+ years of Management or Supervisory experience
  • Proficiency with computer and Windows PC applications
  • Intermediate level experience using Microsoft Excel & PowerPoint

What the Team is Saying

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The Company
HQ: Eden Prairie, MN
160,000 Employees
Year Founded: 2011

What We Do

Optum, part of the UnitedHealth Group family of businesses, is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together. At Optum, we support your well-being with an understanding team, extensive benefits and rewarding opportunities. By joining us, you’ll have the resources to drive system transformation while we help you take care of your future. We recognize the power of connection to drive change, improve efficiency and make a difference in health care. Join a team where your skills and ideas can make an impact and where collaboration is key to creating technology that produces healthier outcomes.

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Optum Offices

Hybrid Workspace

Employees engage in a combination of remote and on-site work.

Optum has three workplace models that balance the needs of the business and the responsibilities of each role. These models, core on‑site (5 days/week), hybrid (4 days/week) and telecommute or fully remote, vary by country, role and location.

Typical time on-site: Not Specified
HQEden Prairie, MN
Metro Manila, Philippines
Cebu, Philippines
Davao, Philippines
Ann Arbor, MI
Atlanta, GA
Baltimore, MD
Bengaluru, India
Chennai, India
Dallas, TX
Detroit, MI
Dublin, Ireland
Hartford, CT
Houston, TX
Hyderabad, India
Jacksonville, FL
Las Vegas, NV
Letterkenny, Ireland
Louisville, KY
Madison, WI
Minneapolis, MN
Nashville, TN
New Delhi, India
Philadelphia, PA
Phoenix, AZ
Pune, India
Raleigh, NC
San Diego, CA
Washington, DC
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