Supervisor, Enrollment Quality Assurance

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults through Medicare Advantage, fully integrated care models, primary care, and next-generation care delivery.

About the role

The Supervisor, Enrollment Quality Assurance (QA) is responsible for the day-to-day supervision of the enrollment reconciliation and operations specialist staff and the activities related to Medicare health plan members and employer groups.

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 the work between cross-functional departments by coordinating support to Enrollment and Reconciliation (E&R) and Grievance and Appeals (GAD) departments.
• Contribute to team effort by accomplishing related results as needed.
• Improve processes by evaluating existing membership and payment reconciliation data workflows and offering suggestions to Management on implementation or monitoring guidelines for software programs to ensure optimum reconciliation revenue is captured.
• Train staff and monitor work to ensure operations are at the level necessary to meet established guidelines and regulatory requirements.
• Oversee workflow, assign work responsibilities and tasks, and prioritize deliverables in order to meet department goals and objectives.
• Field escalated issues and non-routine questions, providing guidance and direction to team.
• Keep abreast of changes to legislation and regulations which pertain to health insurance procedures.
• Oversee the preparation of reports by collecting, analyzing, and summarizing information and trends; recommend courses of action to management.
• Facilitate and work with management team to fulfill audit requests as needed.
• Maintain staff job results by coaching, counseling, and disciplining employees; planning, monitoring, and appraising job results.
• Supervise/manage others (e.g., hires, performance reviews, corrective action, etc.).
• Actively support the achievement of SCAN’s Vision and Goals.
• Other duties as assigned.

Requirements

• Bachelor's or Technical Degree or equivalent experience required.
• 3+ years of experience in enrollment and reconciliation experience in the Health Care or Health Plan industry.
• Demonstrated supervisory experience.
• Experience in Medicare Advantage is highly preferred.
• Leadership skills to develop others.
• Basic problem-solving skills.
• Good written and verbal communication and interpersonal skills.
• Microsoft Office (Word, Excel, PowerPoint, Outlook, Teams) at an advanced level is required.

Benefits

• Robust Wellness Program
• Generous paid-time-off (PTO)
• Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
• Excellent 401(k) Retirement Saving Plan with employer match and contribution
• Robust employee recognition program
• Tuition reimbursement

Pay

Base salary range: $71,700 to $103,732 per year

Internal title: Sup Recon & Ops

An annual employee bonus program

Schedule

Work Mode: Mostly Onsite