Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - with hospitals and care centers in California, Arizona and Nevada. Today, Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers, we provide increasing support and investment in the latest technologies, finest physicians and state-of-the-art medical facilities. We strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled, qualities that are vital to maintaining excellence in care and service.
The Enrollment Supervisor reports to the Director of Claims Management. In this role, they oversee the eligibility department and are responsible for ensuring health plan enrollment EDI files are processed and loaded accurately and timely. The Enrollment Supervisor assists with developing and maintaining the EDI maps to ensure compliance with health plans, trading partners, and regulatory agencies. The Enrollment Supervisor assists with creating and maintaining policies and procedures and provides staff with continuous training. The Enrollment supervisor works with health plan partners, vendors to resolve issues, identify the root cause, and remediate issues. The Enrollment Supervisor will provide support to other departments by assisting with the maintenance and configuration of in-house eligibility software in support of accurate and timely processing of enrollment files. This position is responsible for supervising the Enrollment Support Representatives to ensure the integrity of the membership data and Primary Care Physician (PCP) assignments in Flowcast (IDX) by obtaining accurate and timely HMO insurance and demographic information from a variety of sources such as patients, providers, health plans, and medical offices. Ensures the accuracy of the information entered into the database for system integrity and reporting purposes. The supervisor manages multiple projects to support enrollment/EDI initiatives as needed.
Minimum Qualifications:
3 years of supervisory experience.
3 years of managed care enrollment experience
3 years’ experience supporting EDI (ANSI- X 270) transactions within the healthcare industry
2 years providing support to EDI projects
Preferred Qualifications:
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