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Supervisor, Medicare Enrollment
Centene Corporation. Monitor and oversee Medicare enrollment operations, regulatory audits, and related initiatives impacting membership for product lines and health plans .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in Medicare enrollment operations, compliance risk identification, and audit preparation, while effectively managing staff performance and operational excellence programs. Strong analytical problem-solving skills and proficiency in Microsoft Excel enhance the ability to drive process improvements and meet regulatory standards.
Highest-signal resume keywords
Medicare Enrollment ExperienceAudit PreparationRoot Cause AnalysisMicrosoft Excel SkillsSupervisory Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medicare Enrollment TransactionsMember MaintenanceCancellationsDisenrollmentsReinstatementsCMS Processing RequirementsDocumentation ValidationFindings AnalysisProcess ImprovementBusiness Operations Experience
Soft Skills
Analytical Problem-SolvingStaff ManagementRelationship DevelopmentStakeholder CollaborationTraining Oversight
Industry Keywords
CMSRegulatory ComplianceManaged CareHealth PlansEnrollment and BillingContact Center OperationsClaims ManagementProvider Data Management
About the role
Key responsibilities & impact- Monitor and oversee Medicare enrollment operations, regulatory audits, and related initiatives impacting membership for product lines and health plans
- Manage service levels and audit readiness
- Identify compliance risks, root causes, service opportunities, and process improvements
- Oversee implementation of quality and operations excellence programs
- Monitor production status to ensure production and quality goals are met
- Prioritize daily work volumes
- Hire, train, and manage staff performance
- Monitor service levels for compliance with state, federal, and company metrics and standards
- Support special projects, process improvement evaluations, department business development, and ROI analysis
- Partner with stakeholders on membership-related initiatives, including business needs, strategy recommendations, project outlines, deliverables, and ROI
- Develop and maintain relationships with health plans, IT partners, and other business units
- Oversee training and business processes
- Perform other assigned duties and comply with policies and standards
Requirements
What you’ll need- Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future
- Strong Medicare enrollment experience highly preferred, including enrollment transactions, member maintenance, cancellations, disenrollments, reinstatements, and CMS processing requirements
- Experience with CMS, state, corporate compliance, or other highly regulated operational audits highly preferred
- Experience with audit preparation, documentation validation, findings, and root cause analysis highly preferred
- Strong root cause analysis and analytical problem-solving skills highly preferred
- Intermediate to advanced Microsoft Excel skills highly preferred, including formulas, pivot tables, graphs, and charts
- Must be available Monday through Friday, 8:00 a.m. to 5:00 p.m. Eastern Time
- Associate's degree in Business or related field or equivalent experience required
- 2+ years supervisory/lead experience or management of large projects required
- 2+ years business operations experience in enrollment and billing, contact center, claims, customer service, provider data management, or similar operations required
- 2+ years experience in managed care and/or Medicare environment preferred
- Up to 10% travel based on audit needs
Benefits
Comp & perks- Competitive pay
- Health insurance
- 401K plan
- Stock purchase plans
- Tuition reimbursement
- Paid time off plus holidays
- Flexible approach to work with remote, hybrid, field or office work schedules
- Additional forms of incentives may be included in total compensation, subject to eligibility