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SCAN

Not-for-profit Medicare Advantage plan for seniors

Enrollment Quality Assurance Supervisor

Business OperationsConfirmed live in the last 24 hours
Full-timeLong Beach, CA, USA$71.7k - $103.7k /yr

About the Job

Requirements

  • A bachelor's or technical degree, or equivalent experience, is required.
  • At least 3 years of enrollment and reconciliation experience in the health care or health plan industry is required.
  • Demonstrated supervisory experience is required.
  • Basic skills in developing others are required.
  • Basic problem-solving skills are required.
  • Good written and verbal communication and interpersonal skills are required.
  • Advanced proficiency in Microsoft Word, Excel, PowerPoint, Outlook, and Teams is required.
  • A background check is required.

Responsibilities

  • Oversee data workflows and daily enrollment reconciliation and operations specialist tasks to ensure timely and accurate outcomes.
  • Maintain professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, and participating in professional societies.
  • Monitor work between cross-functional departments by coordinating support to Enrollment and Reconciliation and Grievance and Appeals departments.
  • Improve processes by evaluating existing membership and payment reconciliation data workflows and offering suggestions to management on implementing or monitoring software program guidelines to ensure optimum reconciliation revenue is captured.
  • Train staff and monitor work to ensure operations meet established guidelines and regulatory requirements.
  • Oversee workflow, assign work responsibilities and tasks, and prioritize deliverables to meet department goals and objectives.
  • Field escalated issues and non-routine questions, providing guidance and direction to the team.
  • Keep abreast of changes to legislation and regulations pertaining to health insurance procedures.
  • Oversee preparation of reports by collecting, analyzing, and summarizing information and trends, and recommend courses of action to management.
  • Facilitate and work with the management team to fulfill audit requests as needed.
  • Maintain staff job results by coaching, counseling, and disciplining employees, and by planning, monitoring, and appraising job results.
  • Hire employees, conduct performance reviews, and take corrective action as part of supervising and managing others.
  • Actively support the achievement of SCAN's vision and goals.
  • Perform other duties as assigned.

Desired Qualifications

  • Experience in Medicare Advantage is highly preferred.

About the Company

SCAN

Not-for-profit Medicare Advantage plan for seniors

SCAN provides health coverage for seniors through Medicare Advantage and offers community programs like Independence at Home and Volunteer Action for Aging. Members enroll in SCAN’s Medicare Advantage plan to receive medical benefits, and SCAN also runs in-home care and community services that support aging in place, funded by the organization and partners. It differentiates itself as a not-for-profit with a long history (since 1977) focused on seniors and caregivers and backed by strong employee benefits and community engagement. The goal is to help seniors stay healthy and independent by improving access to care and strengthening the communities the organization serves.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
Long Beach, CA
Founded
1977

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