Manager, Enrollment Operations – Health Plan Enrollment Experience Required

CareSource

. Provide leadership and direction to the Enrollment team .

Posted 9/17/2026full-timeRemote • United StatesMid-LevelSenior💰 $83,000 - $132,800 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates strong leadership in managing enrollment teams, ensuring compliance with regulatory requirements, and overseeing financial and member enrollment processes. Proficient in health plan enrollment, data analysis, and process improvement within a high-pressure environment.

Highest-signal resume keywords

Leadership Management ExperienceHealth Plan Enrollment ProcessesFacets Subscriber and Member SetupRegulatory Compliance KnowledgeEnrollment Reconciliation

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Health Plan EnrollmentEnrollment ReconciliationFacets ProficiencyHIPAA 834 KnowledgeEDI 270/271 UnderstandingDTRR Process KnowledgeRegulatory ReportingDatabase ManagementData AnalysisProcess Improvement

Soft Skills

Effective People ManagementAdvanced Communication SkillsMentoring and CoachingDecision-Making SkillsProblem-Solving Skills

Tools & Technologies

Enrollment TechnologyCustomer Service ApplicationOnline ServicesEligibility Search Functions

Industry Keywords

MedicaidMedicareDual Coverage ProgramsRegulatory ComplianceEnrollment Audit Engagements

About the role

Key responsibilities & impact

Provide leadership and direction to the Enrollment team
Ensure department and CareSource goals and standards are met
Manage staff to ensure timely, accurate, high-quality completion of service items
Oversee financial and member enrollment reconciliation for assigned lines of business
Oversee vendor eligibility extract processes
Ensure compliance with regulatory requirements
Manage enrollment technology and process analysts and activities involving 834 and DTRR file processes and departmental policies and procedures
Manage enrollment audit engagements and develop corrective action plans as needed
Gather, analyze, and report department performance data and recommend process improvements
Participate in development of new products and technologies
Manage daily operations and projects through resource allocation
Develop and maintain knowledge of the company’s business and regulatory environments
Incorporate change and risk management controls
Hire, train, coach, and develop direct reports, including performance appraisals and disciplinary actions
Mentor team leads and team members
Perform other related duties as requested

Requirements

What you’ll need

Bachelor's degree required, or equivalent years of relevant work experience may be accepted in lieu of required education
Three (3) years of leadership/management experience required
Three (3) years of enrollment/reconciliation/call center experience required
Strong understanding of health plan enrollment processes
Expert proficiency in Facets subscriber and member setup, benefits eligibility including COB, and proficiency in the Customer Service application preferred
Knowledge of Medicaid, Medicare, and Dual coverage programs, including enrollment requirements and regulatory compliance
Understanding of HIPAA 834, EDI 270/271, DTRR, MMR, and other industry-standard enrollment files and data exchange processes
Knowledge of enrollment reconciliation preferred
Strong knowledge of regulatory reporting and compliance requirements preferred
Proficient in online services and eligibility search functions
Effective people management/leadership skills
Strong knowledge of database management desired
Knowledge of working with IT teams and providing requirements
Ability to prioritize and execute tasks in a high-pressure environment
Ability to defuse tension and manage conflict
Advanced written and verbal communication skills
Excellent mentoring and coaching skills
Excellent decision-making and problem-solving skills
Strong critical thinking, listening, and analytical thinking skills
Licensure and certification: None required
General office environment; may sit or stand for extended periods

Benefits

Comp & perks

Bonus tied to company and individual performance may be available
Substantial and comprehensive total rewards package
Employee total well-being support