Process Manager, Exchange Enrollment - Schenectady
MVP Health Care - Schenectady, NY

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Under the direction of the Manager, EAS Technical Services: This position serves as the primary person for ensuring optimal enrollment performance and compliance for Exchange membership between the state Exchanges, vendor relationships, and MVP. This position will oversee and monitor the accuracy and integrity of the Exchange electronic enrollment data and is responsible for identifying any errors within the EDI process and coordinating internal and external customers for resolution. Assess policies and procedures to ensure department processes are within state regulations. Implement Exchange rules and regulations as they relate to the EAS department. Represents enrollment in Exchange related projects, external vendor meetings, and/or state Exchange conferences. Performs monthly audits/reconciliations of enrollment processes in accordance to Exchange auditing/reconciliation guidelines, documents and provides results to management. Maintain relationship with IT and vendor contact for assistance in system upgrades and ongoing items and enhancements. Performs other projects/duties as assigned. Minimum Education: AAS/BS degree preferred or equivalent experience required in health plan business operations. Minimum Experience: 4 years experience with eligibility of member and group enrollment in Health Care/Health Insurance required. Understanding and experience with 834 file layouts, Group Set up processes, and analytical/process improvement. Required Skills: Experience with research and problem resolution. Strong analytical and organizational skills. Excellent written and verbal communication skills. Experience monitoring and evaluating performance of operational activities. Word and Excel experience, Access preferred. Must be detail-oriented and have the ability to work independently .Strong meeting facilitating and presentation skills. Minimal travel. Facets experience


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MVP Health Plan covers about 650,000 most valuable people. Also known as MVP Health Care, the company provides health insurance and employee...