Job Overview
Location
Idaho WFH
Job Type
Full-time
Category
HR & Recruiting
Date Posted
March 27, 2026
Full Job Description
đź“‹ Description
- • The Manager, Enrollment Operations provides leadership and direction to the Enrollment team to ensure departmental and organizational goals are met, with a focus on maintaining high-quality outputs, operational efficiency, and regulatory compliance across all lines of business. This role is critical to ensuring accurate and timely enrollment processing, reconciliation, and vendor management, directly impacting member experience and organizational integrity.
- • Day-to-day responsibilities include overseeing enrollment end-to-end processes, managing staff to ensure timely and accurate completion of service items, supervising financial and member enrollment reconciliation, and monitoring vendor eligibility extract processes for accuracy and timeliness. The manager also leads enrollment technology and process analysts, manages audit engagements, develops corrective action plans, gathers and analyzes performance data for process improvement, and actively contributes to new product and technology development.
- • The Enrollment Operations team operates within CareSource Management Group Company, a mission-driven healthcare organization dedicated to improving access to quality care for underserved populations. The team collaborates closely with IT, compliance, finance, and clinical departments to ensure seamless enrollment operations aligned with regulatory standards and organizational objectives.
- • In this role, the individual will develop deep expertise in healthcare enrollment systems, regulatory frameworks (including Medicaid, Medicare, and Dual programs), and data exchange standards such as HIPAA 834, EDI 270/271, and DTRR. They will strengthen leadership, change management, and analytical skills while driving process improvements that enhance member experience and organizational effectiveness.
🎯 Requirements
- • Bachelor's degree required (or equivalent years of relevant work experience)
- • Three (3) years of leadership/management experience required
- • Three (3) years of enrollment/reconciliation/call center experience required
- • Strong understanding of health plan enrollment processes and knowledge of Medicaid, Medicare, and Dual coverage programs
- • Expert proficiency in Facets subscriber and member setup, benefits eligibility (including COB), and proficiency in Customer Service application preferred
- • Understanding of HIPAA 834, EDI 270/271, DTRR, MMR, and other industry-standard enrollment files and data exchange processes
- • Effective people management/leadership skills, advanced communication skills (written and verbal), and ability to work with multi-disciplinary departments
- • Strong critical thinking, analytical thinking, decision-making, and problem-solving skills
- • Ability to prioritize and execute tasks in a high-pressure environment and defuse tension/manage conflict among teams
🏖️ Benefits
- • Competitive salary range of $83,000.00 - $132,800.00
- • Bonus tied to company and individual performance
- • Substantial and comprehensive total rewards package focused on employee total well-being
- • Opportunity to work remotely (Idaho WFH)
- • Professional development through mentoring, coaching, and leadership responsibilities
- • Exposure to healthcare regulatory environments and enrollment technology systems
- • Collaborative workplace culture with emphasis on fostering partnerships and developing self and others
Skills & Technologies
Onsite
Degree Required
About CareSource Management Group Company
CareSource is a nonprofit, multi-state managed care organization headquartered in Dayton, Ohio. Founded in 1989, it administers Medicaid, Medicare Advantage, and Marketplace health plans serving over two million members in Ohio, Kentucky, Indiana, West Virginia, and Georgia. The company focuses on improving health outcomes for low-income and vulnerable populations through integrated care management, behavioral health services, and social determinants programs.
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