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Director of Enrollment Strategy
hace 2 meses
Lhh is seeking a highly skilled and experienced Director of Enrollment Management to lead our enrollment processes and ensure seamless access to essential health services. As a key member of our team, you will be responsible for developing and implementing strategic initiatives to drive operational efficiency and optimize enrollment systems.
Key Responsibilities:- Manage eligibility, benefits, and coverage determination strategies across multiple states (AZ, UT, DC, OK).
- Develop strategic initiatives to address state-by-state variations in benefits and payer requirements.
- Knowledge of Medicare, Medicaid, Tricare, commercial insurance, and federal funding mechanisms to manage payer relations and ensure compliance with payer contracts.
- Recommend process improvements for managing discrepancies across payers.
- Use data analytics tools (Power BI, Excel) to identify trends in population data, discrepancies in coverage, and opportunities for improved payer relations and business growth.
- Supervise a team of enrollment specialists, guiding them in managing enrollment, eligibility, and benefit processes, including resolving issues with payers and tracking enrollment trends.
- Ensure daily compliance reporting for individuals lacking appropriate coverage.
- Work closely with inpatient and outpatient leadership, claims, IT, and payers to ensure benefits and eligibility are managed in line with regulatory standards (CFR, AAC).
- Develop and oversee internal audits and controls to minimize discrepancies, ensuring payers are updated on changes, and maintaining proper enrollment processes.
- Collaborate with departments such as Utilization Review (UR), Billing, Contracting, and IT to streamline communication and improve cross-functional operations.
- Bachelor's degree in behavioral health, healthcare administration, or a related field (Master's degree preferred).
- A minimum of 3 years of behavioral health experience, particularly in eligibility verification, benefit management, and enrollment.
- A minimum of 5 years of progressive management experience, ideally within the behavioral health industry.
- In-depth knowledge of Medicaid, commercial insurance, and public healthcare systems.
- Expertise in navigating complex regulations, including CPT, HCPC, and Revenue Codes.
- Ability to access and interpret benefits for various healthcare funding streams (e.g., Medicaid, SUBG, MHBG, SOR).
- Generous PTO accrual (5 weeks).
- Medical, Dental, Vision, Disability, Life, Supplemental plans.
- Hospital indemnity/Critical Illness.
- Pet Insurance.
- Dependent Care Savings.
- Health Care Savings.
- 401K with employer match - 100% vested upon enrollment.
- Wellness programs.
- Tuition Reimbursement and Scholarship Programs.
- Incentives.
