Healthcare Operations Manager
3 days ago
We are seeking a highly skilled and experienced Healthcare Operations Manager to join our team at Apex Health Solutions. As a key member of our member concierge team, you will be responsible for managing the functional areas and staff that perform eligibility and enrollment operations.
Key Responsibilities:
- Develop and maintain proper controls to ensure inbound and outbound data and documents are processed within expected performance standards.
- Maintain communication with all internal and external enrollment production teams to ensure deadlines are met and quality checks are performed.
- Establish and maintain quality assurance programs to monitor in- and outbound billing and eligibility file accuracy.
- Monitor operations and performance of external vendors to ensure accuracy and production standards are met.
- Manage daily enrollment and disenrollment operations related to beneficiaries in Medicare Advantage products.
- Oversee the assistance to individuals and families in navigating and/or enrolling in programs and services.
Requirements:
- Bachelor's Degree in healthcare administration, business, or related field.
- Firm grasp of CMS regulations and requirements.
- Experience with all aspects of Medicare enrollment.
- Proficient analytical and research abilities.
- Excellent verbal and written communication skills.
About Apex Health Solutions
We power payers and providers choosing to engage in value-based risk contracting. Our unique solutions create alignment between payers and providers, generating unparalleled value. Combined with our experienced and successful industry leadership, our focal point remains on improvement inpatient quality, satisfaction, and overall cost of care.
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