Eligibility/Enrollment Manager

SUMMARY:
The Eligibility/Enrollment Manager is responsible for providing leadership, oversight and expertise to the Eligibility/Enrollment team. This role ensures accurate and timely administration of participant eligibility and enrollment, including benefits coverage verification, status changes and related inquiries. The position will oversee one or more teams, such has Active and Retiree Enrollment, COBRA, and Death Benefits.

ESSENTIAL DUTIES AND RESPONSIBILITIES:
Management reserves the right to assign additional responsibilities as needed to meet operational requirements.

• Ensure departmental goals and key performance indicators are met or exceeded, aligning team objectives with the overall mission of the Fund.
  
• Evaluate existing business processes, perform high-level analyses, and identify opportunities for operational improvement and efficiency gains.
  
• Maintain accountability for timely and accurate processing of enrollment and eligibility transactions in accordance with Plan provisions and applicable regulatory requirements.
  
• Lead the implementation of standard work practices to ensure that strong internal controls and compliance measures are in place and adhered to at all times.
  
• Manage and oversee daily workflow and departmental productivity, including preparation and review of daily, weekly, monthly production and inventory reports to ensure department objectives and service standards are achieved.
  
• Serve as point of accountability for the performance and deliverables of any assigned vendors.
  
• Hire, coach, counsel, and evaluate performance of direct reports, fostering a culture of accountability collaboration and professional growth that models the Fund’s mission, vision and values.
  
• Maintain a thorough understanding of Plan documents, summaries of Plan provisions and participant materials to ensure departmental knowledge remains current and accurate.
  
• Adhere to the company’s attendance policy.
  
• Comply with the policies of the Trust Fund, as set forth in the Employee Handbook.
  
• Abide by organizational and HIPAA guidelines, privacy practices, and confidentiality.
  

QUALIFICATION REQUIREMENTS:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily, including regular and consistent attendance and must be able to handle sensitive benefits data. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE:

• High School diploma or GED required.
  
• Associate’s or Bachelor’s degree in a related field or a combination of education and experience highly preferred.
  
• Minimum of 5 years’ experience in benefits administration, eligibility or a related role.
  
• Minimum of 5 years’ experience in a managerial or supervisory position.
  
• Prior experience working within a Taft-Hartley multi-employer benefit fund is highly preferred.
  
• Proficient in Microsoft Office Suite.
  

OTHER SKILLS and ABILITIES:

• Excellent communication and interpersonal skills.
  
• Highly organized and detailed oriented.
  
• Ability to take initiative and work independently.
  
• Strong problem-solving and decision making skills.
  
• Ability to manage multiple tasks and meet deadlines.
  
• Customer orientation and ability to adapt/respond to different types of individuals.
  
• Dedication to upholding the company’s mission, vision and values.
  
• Cultivate a productive and collaborative work environment.
  
• Basic math and reading competencies.