Senior Representative, Enrollment (Remote)
Molina Healthcare Roswell, New Mexico; Everett, Washington; Bellevue, Nebraska; Boise, Idaho; Sterling Heights, Michigan; Chandler, Arizona; Georgia; Rio Rancho, New Mexico; Michigan; St. Petersburg, Florida; Ann Arbor, Michigan; Austin, Texas; Caldwell, Idaho; Augusta, Georgia; Detroit, Michigan; Tacoma, Washington; Tampa, Florida; Iowa; Texas; Washington; Des Moines, Iowa; Tucson, Arizona; Omaha, Nebraska; Phoenix, Arizona; Cleveland, Ohio; Savannah, Georgia; Orlando, Florida; Milwaukee, Wisconsin; Utah; Vancouver, Washington; Columbus, Ohio; Wisconsin; Davenport, Iowa; Racine, Wisconsin; Jacksonville, Florida; Grand Rapids, Michigan; Houston, Texas; Miami, Florida; Grand Island, Nebraska; Idaho Falls, Idaho; Cedar Rapids, Iowa; Bowling Green, Kentucky; Syracuse, New York; Madison, Wisconsin; Lincoln, Nebraska; Nampa, Idaho; Covington, Kentucky; Dallas, Texas; Warren, Michigan; Scottsdale, Arizona; New Mexico; Louisville, Kentucky; Fort Worth, Texas; New York; Iowa City, Iowa; Akron, Ohio; Layton, Utah; San Antonio, Texas; Spokane, Washington; Owensboro, Kentucky; Rochester, New York; Atlanta, Georgia; Salt Lake City, Utah; Provo, Utah; Meridian, Idaho; Cincinnati, Ohio; Columbus, Georgia; Idaho; Kearney, Nebraska; Orem, Utah; Albany, New York; West Valley City, Utah; Sioux City, Iowa; Green Bay, Wisconsin; Lexington-Fayette, Kentucky; Kenosha, Wisconsin; Ohio; Kentucky; Dayton, Ohio; Santa Fe, New Mexico; Albuquerque, New Mexico; Las Cruces, New Mexico; Buffalo, New York; Bellevue, Washington; Yonkers, New York; Macon, Georgia; Mesa, Arizona; Florida; Nebraska Job ID 2032139JOB DESCRIPTION
Job Summary
The Sr Rep, Enrollment handles all processes related to membership eligibility inquiries and ensures membership accuracy within the system. Represents Enrollment Operations as a subject matter expert (SME) and works collaboratively with external clients and internal partners to resolve membership issues. Utilizes multiple applications and has deep understanding of eligibility related processes.
KNOWLEDGE/SKILLS/ABILITIES
- Completes operational processes to resolve eligibility issues including but not limited to incoming/outgoing eligibility
- Reconciles eligibility information with State or Federal Agencies using varied methods.
- Analyzes and assist with complex eligibility issues and provides resolution to internal partners and external clients. and regulators
- Responds, documents and tracks and quality assures all proceedings with State and/or Federal Agencies. (including member complaints) within required SLAs (Service Level Agreements)
- Utilize critical thinking skills to proactively communicate eligibility issue trends with Management.
- Manages high volumes of tasks to support regulatory requirements and service level agreements and competing priorities.
Contributes to technical system enhancements by performing user testing.
• Participate as a team player by assisting peers and Management to support department goals.
• Trains new staff on assignments and/or vendors on assignments
- Serves as the Subject Matter Expert (SME) to support production and provides knowledgeable responses to internal and external inquiries regarding eligibility, ID cards, selection of primary care provider, and state enrollment transactions.
- Prioritizes daily, weekly and monthly job tasks to support regulatory requirements and service level agreements.
- Support special projects including regulatory audits
- Resolves the following eligibility exceptions within the required State/Regulatory timeframes.
- Displays initiative to complete assigned tasks timely and accurately and balances workload to assist peers and leadership team.
- Strong knowledge of Enrollment processing for Federal, State, and business regulatory requirements.
- Assist with complex enrollment issues concerning member eligibility.
- Quality review and submission of deliverables to Molina Healthcare Government Contract and to State Medicaid Agencies.
JOB QUALIFICATIONS
Required Education
Associate degree or equivalent combination of education and experiences
Required Experience
- 1-3 years related work experience
- Intermediate Microsoft Excel and Microsoft Word
Preferred Education
Bachelor's Degree or equivalent combination of education and experiences
Preferred Experience
- 3-5 years related work experience
- Basic knowledge ANSI X12 834
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $21.16 - $34.88 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type: Full Time Posting Date: 06/12/2025ABOUT OUR LOCATION
View Map- Director, Operational Oversight (Medicare/Duals) - REMOTE West Valley City Utah, Columbus Ohio, Vancouver Washington, Owensboro Kentucky, Florida, Washington, New Mexico, Cedar Rapids Iowa, Orem Utah, Albuquerque New Mexico, Madison Wisconsin, Kenosha Wisconsin, Fort Worth Texas, Milwaukee Wisconsin, New York, Tacoma Washington, Michigan, Spokane Washington, Austin Texas, Bellevue Washington, Bowling Green Kentucky, San Antonio Texas, Las Cruces New Mexico, Nampa Idaho, Sterling Heights Michigan, Cincinnati Ohio, Provo Utah, Bellevue Nebraska, Ohio, Miami Florida, Detroit Michigan, Kearney Nebraska, Iowa City Iowa, Phoenix Arizona, Syracuse New York, Grand Rapids Michigan, Buffalo New York, Savannah Georgia, Lincoln Nebraska, Lexington-Fayette Kentucky, Louisville Kentucky, Santa Fe New Mexico, Utah, Everett Washington, Macon Georgia, Idaho Falls Idaho, Tucson Arizona, Roswell New Mexico, Racine Wisconsin, Dallas Texas, Des Moines Iowa, Caldwell Idaho, Wisconsin, Iowa, Jacksonville Florida, Layton Utah, Salt Lake City Utah, Covington Kentucky, Meridian Idaho, Chandler Arizona, Tampa Florida, Boise Idaho, Kentucky, Green Bay Wisconsin, Texas, Houston Texas, Yonkers New York, Grand Island Nebraska, Dayton Ohio, Warren Michigan, Rio Rancho New Mexico, Georgia, Nebraska, Omaha Nebraska, Davenport Iowa, Orlando Florida, Columbus Georgia, Akron Ohio, Cleveland Ohio, Sioux City Iowa, Mesa Arizona, Ann Arbor Michigan, St. Petersburg Florida, Scottsdale Arizona, Augusta Georgia, Atlanta Georgia 07/11/2025
- Senior Solution Architect Georgia, New York, Detroit Michigan, New Mexico, Racine Wisconsin, Cedar Rapids Iowa, Augusta Georgia, Layton Utah, Des Moines Iowa, Sterling Heights Michigan, Ann Arbor Michigan, West Valley City Utah, Savannah Georgia, Syracuse New York, Grand Rapids Michigan, Everett Washington, Idaho Falls Idaho, Provo Utah, Texas, Wisconsin, Rochester New York, Bowling Green Kentucky, Cincinnati Ohio, St. Petersburg Florida, Vancouver Washington, Orlando Florida, Ohio, Idaho, Tucson Arizona, Kearney Nebraska, Dallas Texas, Meridian Idaho, Phoenix Arizona, Scottsdale Arizona, Houston Texas, Macon Georgia, Washington, Utah, Yonkers New York, Columbus Georgia, Iowa City Iowa, Tampa Florida, Nampa Idaho, Green Bay Wisconsin, Warren Michigan, Davenport Iowa, Boise Idaho, Lincoln Nebraska, Madison Wisconsin, Spokane Washington, Austin Texas, Iowa, Atlanta Georgia, Miami Florida, Dayton Ohio, Jacksonville Florida, San Antonio Texas, Kenosha Wisconsin, Chandler Arizona, Caldwell Idaho, Albuquerque New Mexico, Albany New York, Salt Lake City Utah, Florida, Michigan, Rio Rancho New Mexico, Tacoma Washington, Bellevue Nebraska, Cleveland Ohio, Sioux City Iowa, Santa Fe New Mexico, Bellevue Washington, Milwaukee Wisconsin, Grand Island Nebraska, Kentucky, Columbus Ohio, Roswell New Mexico, Akron Ohio, Louisville Kentucky, Fort Worth Texas, Lexington-Fayette Kentucky, Orem Utah, Las Cruces New Mexico, Nebraska, Mesa Arizona, Buffalo New York, Covington Kentucky, Omaha Nebraska, Owensboro Kentucky 06/25/2025
- Hospice Oversight Care Manager (RN) California Burbank California, Glendale California, Simi Valley California, Santa Monica California, Compton California, Carson California, Irvine California, San Francisco California, Sacramento California, Torrance California, Huntington Beach California, Corona California, Temecula California, Apple Valley California, San Jose California, San Diego California, Fresno California, Los Angeles California, San Bernardino California, Riverside California, Long Beach California 02/11/2025
- Lead Analyst, Claims/ Regulatory Compliance - Marketplace Covington Kentucky, Phoenix Arizona, Santa Fe New Mexico, Syracuse New York, Detroit Michigan, Austin Texas, Owensboro Kentucky, West Valley City Utah, Lincoln Nebraska, Tacoma Washington, Akron Ohio, Idaho, Utah, San Antonio Texas, Cleveland Ohio, Orlando Florida, Vancouver Washington, Las Cruces New Mexico, Cincinnati Ohio, Bellevue Washington, Bellevue Nebraska, Caldwell Idaho, Dallas Texas, Kearney Nebraska, Rochester New York, Atlanta Georgia, Savannah Georgia, Green Bay Wisconsin, Nampa Idaho, Davenport Iowa, Kentucky, Iowa, Michigan, Madison Wisconsin, Mesa Arizona, Kenosha Wisconsin, Grand Island Nebraska, Layton Utah, Texas, New Mexico, Ohio, Nebraska, Orem Utah, Lexington-Fayette Kentucky, Boise Idaho, Spokane Washington, Grand Rapids Michigan, Buffalo New York, Salt Lake City Utah, Idaho Falls Idaho, Albany New York, Meridian Idaho, Warren Michigan, Louisville Kentucky, Rio Rancho New Mexico, Des Moines Iowa, Miami Florida, Omaha Nebraska, Ann Arbor Michigan, Houston Texas, Provo Utah, Columbus Ohio, Augusta Georgia, Sioux City Iowa, Dayton Ohio, Georgia, New York, Florida, Washington, Scottsdale Arizona, Tampa Florida, Macon Georgia, Milwaukee Wisconsin, Sterling Heights Michigan, Columbus Georgia, St. Petersburg Florida, Racine Wisconsin, Iowa City Iowa, Jacksonville Florida, Wisconsin, Bowling Green Kentucky, Albuquerque New Mexico, Yonkers New York, Everett Washington, Chandler Arizona, Fort Worth Texas, Tucson Arizona, Roswell New Mexico, Cedar Rapids Iowa 06/16/2025