Job Description:

We offer remote work opportunities (AK, AR, AZ, CA, *CO, FL, *HI, IA, ID, IL, KS, LA, MD, MN, MO, MT, NE, NV, NM, NC, ND, OK, OR, SC, SD, TN, TX, UT, VA/DC, *WA, WI & WY only).

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Veterans, Reservists, Guardsmen and military family members are encouraged to apply!

Job Summary

Manages the Enrollment Production operations and staff to ensure accurate and timely service and compliance with TriWest and TRICARE policies and procedures. Manages staff issues, quality, performance, policies and procedures, on-line systems issues, and inter-department communication and collaboration. Manages Enrollment Production staff including Supervisor(s), Team Lead(s), Clerical Team, Enrollment Service Representatives and the internal escalation line.

Education & Experience

Required:

• Bachelor's Degree in Business, Healthcare Administration, or related field or equivalent experience
• 5+ years' experience in membership and billing with at least two years of supervisory experience.

Key Responsibilities

• Ensures that Enrollment Production department generates accurate and timely enrollment actions and provides optimal service. Ensures that enrollment applications processing complies with department standards, TRICARE and government regulations, guidelines, and requirements.
• Manages department's operations to achieve operational goals and operate within budget constraints.
• Oversees supervisors with scheduling, special projects, and coaching staff on performance issues. Coaches and mentors supervisory team on contract modifications and TRICARE fundamentals. Ensures staff development.
• Sponsors, manages and participates on special projects with cross-functional teams, including senior leadership from TriWest, TriWest's subcontract partners, Defense Health Agency (DHA), and other applicable TRICARE departments.
• Ensures timely and effective resolution of beneficiary enrollment processes. Oversees related correspondence between Enrollment and the Contact Center and other customer service operations departments.
• Represents Enrollment leadership at meetings as necessary, for the Director, Enrollment.

• Monitors operational effectiveness by monitoring employee performance score cards, audits and system tests. Tracks Enrollment's service levels through CRM and other systems.
• Researches and diagnoses issues to identify opportunities for process improvement by collaborating with other departments, project managers, and staff coordinators. Develops metrics and monitors outcomes to identify areas for improvement.
• Coordinates customer service efforts to resolve complex enrollment issues with other TriWest departments and external entities, including TriWest's subcontract partners, Congressional and Customer Relations, Health Care Services, Contract Management, Claims, and Provider Services.
• Ensures complete and prompt resolution to any issues requiring Enrollment intervention. Collaborates with others to execute resolution, including TriWest department management and Field Operations.

.:

• Maintains accurate, updated departmental desk procedures for Enrollment staff.
• Participates in projects, cross-functional teams, meetings, and conferences as required.
• Performs other duties as assigned
• Regular and reliable attendance is required.

Competencies

Coaching / Training / Mentoring: Actively fosters actions required for desired business outcomes through ongoing constructive feedback.

Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; adapts to different styles; listens critically; collaborates.

Computer Literacy: Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.

Coping / Flexibility: Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required.

Information Management: Ability to manage large amounts of complex information easily, communicates clearly, and draws sound conclusions.

High Intensity Environment: Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.

Leadership: Successfully manages different styles of employees; provides clear direction and effective coaching.

Multi-Tasking / Time Management: Prioritizes and manages actions to meet changing deadlines and requirements within a high volume, high stress environment.

Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented.

Technical Skills: Thorough knowledge of performance measurement tools and process improvement techniques; working knowledge of TRICARE program, including ability to analyze, apply, interpret and communicate policy, procedures and regulations; advanced Excel and PowerPoint and Web-based applications skills; strong collaboration skills for cross-functional issues.

Working Conditions

Working Conditions:

• Works non-regular hours as necessary
• Works within a standard office environment, with minimal travel
• Department of Defense security clearance required

Company Overview

Taking Care of Our Nation's Heroes.

It's Who We Are. It's What We Do.

Do you have a passion for serving those who served?

Join the TriWest Healthcare Alliance Team! We're On a Mission to Serve®!

Our job is to make sure that America's heroes get connected to health care in the community.

At TriWest Healthcare Alliance, we've proudly been on that important mission since 1996.

DoD Statement

Our Department of Defense contract requires US citizenship and a favorably adjudicated DOD background investigation for this position.

Benefits

We're more than just a health care company. We're passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:

• Medical, Dental and Vision Coverage


• Generous paid time off


• 401(k) Retirement Savings Plan (with matching)


• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance


• Tuition reimbursement


• Paid volunteer time

*Annual base salary for Colorado, Hawaii, Washington D.C. and Washington State residents: $87,000- $110,000 depending on experience*

Equal Employment Opportunity

TriWest Healthcare Alliance is an equal employment opportunity employer. We are proud to have an inclusive work environment and know that a diverse team is a strength that will drive our success. To that end, TriWest strives to create an inclusive environment that cultivates and supports diversity at every organizational level, including hiring and retaining a diverse workforce, and we highly encourages candidates from all backgrounds to apply. Applicants are considered for positions without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability or any other consideration made unlawful by applicable federal, state, or local laws.

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