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Manager I Enrollment Data (Med...


Job Summary

New York, NY
Other/Not Classified
Job Type
Full Time
Career Level
Experienced (Non-Manager)
Job Reference Code

Manager I Enrollment Data (Medicaid Operations) - Pine St., NYC - PS5075

About the Job


Your Talent. Our Vision. At Empire Blue Cross Blue Shield, a proud member of the Anthem, Inc. family of companies, it's a powerful combination, and the foundation upon which we're creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve.

The Mgr. I Enrollment Data manages and coordinates the Enrollment Department functions to ensure the accurate and timely update of the Enrollment database, redirecting the focus of the department activities, as necessary, to meet deadlines. Oversees workflow and productivity, utilizing in-depth knowledge of all Enrollment policies and processes to guide and educate the Enrollment staff. Responsible for the timely notification to the Health Plans, other corporate departments and State representatives, as necessary, of enrollment issues that may impact the timely load of enrollment data.

Primary responsibilities including, but not limited to:

Manages staff to meet or exceed department goals, including productivity metrics, quality and timeliness standards as defined by department guidelines.

Reviews and analyzes contract changes for impact on enrollment processes; implements procedures in concert with contract requirements and federal and state laws.

Oversees the development of necessary user documentation and process flows to assist in the support and training of staff. Ensures documentation of all procedures.

Maintains in-depth, current knowledge of contractual and legal/regulatory requirements for multiple markets.

Assists in the development of policy and procedures for the Enrollment Department, and ensures adequate internal controls, including SOX and HIPAA controls, exist for all processes. Participates in market audits as needed.

Serves as Subject Matter Expert and liaison for technical projects.

Coordinates and interfaces with implementation team on new market/product implementations. Review and analyze contract changes for impact on the enrollment processes.

Oversee the development of necessary technical and user documentation to assist in the support and training of the staff. Ensure the documentation of all procedures.

Reviews and determines areas of improvement within the department and makes adjustments to achieve best performance possible, working with other impacted departments at the corporate and plan level as appropriate.

Responsible for recruiting, hiring, managing performance, ensuring compliance with all regulatory requirements, training and coach staff.


Bachelors Degree in Health Care Management, Finance or Business or equivalent experience. 5+ years experience in Enrollment in the healthcare industry, with at least one year of leadership/supervisory experience, or any combination of education and experience that would provide an equivalent background.

-Medicaid, managed care experience preferred.

-Evidence of leadership/people management experience required.

-Experience working in Medicaid operations (enrollment, claims, finance, etc.)

-Computer skills - MS Office (Word, Outlook, Excel). Must be able to review and analyze reports. Experience working with large enrollment data preferred.

Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.


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