Manager, Eligibility & Enrollment
About the role
Our Eligibility & Enrollment team is the front door to the member experience — we process every enrollment, disenrollment, plan change, and retroactive adjustment across our HMO, PPO, and Special Needs Plan products, and we own the CMS transactions that make membership accurate and auditable. As Manager, you'll turn departmental strategy into daily workflows, production targets, and staff assignments, keeping the work compliant with CMS requirements and on time. You'll report to the Senior Manager, Eligibility & Enrollment and lead a team of Enrollment/Eligibility Associates. This is a hands-on operational leadership role: you'll be in the queues, in the data, and in the escalations, while building the reporting and controls the team runs on. Your results show up directly in CMS transaction accuracy and timeliness, inventory aging, quality audit scores, and the member experience measures tied to enrollment accuracy.
Responsibilities
- Managing daily workflow, work queues, and transaction inventory so enrollments, disenrollments, plan changes, cancellations, and retroactive adjustments across HMO, PPO, and SNP products clear within CMS and internal