Director Billing amp Enrollment - Humana Military

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Job Information
Humana
Director, Billing & Enrollment - Humana Military
in
Portsmouth
New Hampshire
Description
CEBO is an organization that is responsible for key Billing and Enrollment functions in support of the TRICARE East Managed Care Support Contract. The CEBO team performs enrollment processing, payment set-up and reconciliation, resolution of telephonic and digital customer inquiries, primary care manager PCM assignments and changes, Maintenance of Military Treatment Facility (MTF) preferences and assignment rules, and other health insurance (OHI) information collection within policies and contract performance metrics defined within our contract with the Defense Health Agency (DHA).
Our Government Contract Requires US Citizenship for this Position
The Director will play a key leadership role on the Humana Government Business Beneficiary Services team, partnering directly with the Beneficiary Services Leadership team and other leaders across the enterprise, including Market leadership, and external stakeholders such as DHA to create strategies to support Humana Government Business' industry leading position. This person will also establish relationships with external vendors whose products may be valuable resources for supporting our business goals, or viable solutions to business challenges that have been identified. In addition, the Director will serve as a central point of contact for the enterprise as relates to key billing and enrollment initiatives.
In this role, the Director will explore opportunities to increase efficiency and quality at a more operational level while creating an environment that fosters associate development and engagement. This position will report directly to the Associate Vice President for Strategy Advancement, Beneficiary Services and can be based anywhere within the lower 48 states.
Responsibilities
The Director of Billing and Enrollment shall be accountable to the Group Military and Specialty Business Leadership team and the Management Team to:
Develop and deliver on Strategy playbook focused on optimization of talent, technology and processes .Deliver on a wide range of strategy and development activities, including department level strategy and convert strategy/development priorities into business cases and projects while prioritizing timelines and ensuring consensus and execution
Ensure contract and enterprise policies are adhered to and performance metrics are met. Identify and communicate for performance risks including mitigation plans to Senior leadership. Partner to develop monitoring and controls as needed.
Provide transparency and reporting for short-term priorities and identify long-term process goals.
Lead process improvement initiatives focused on improving the customer experience, leveraging automation and driving reduced cycle time and increased NPS, while prioritizing and optimizing the portfolio
Ensure that the identified opportunities for budgeted administrative savings are realized.
Build an environment that optimizes associate engagement
Partner with Business Development, Government Services and Executive Leadership to ensure focus on new and future TRICARE policy or other business development opportunities.
Manage Operational Performance Metrics defined by our TRICARE contract and organizational leadership. Directly responsible for billing and enrollment contract metrics, and indirectly responsible for adjacent metrics. Must work cross-functionally to ensure end to end metrics and customer experience are delivered; including second-level beneficiary calls.
Represent CEBO in monthly performance summary discussions with DHA and other key meetings, committees, to ensure all CEBO impacts and opportunities are considered.
Required Qualifications
Bachelor's Degree
Billing & enrollment experience & clear ability to build / fix vs. 'lead steady state'
5 or more years of senior level management experience in a member driven organization
5 or more years of experience managing large scale projects or programs
Experiencing managing a performance based culture
Must be passionate about contributing to an organization focused on continuously improving consumer experiences
Desired Qualifications
Master's degree
Healthcare experience
Additional Information
Travel required: up to 25%
Primary Location - Office or Remote, eastern or central time zone
We will require full COVID vaccination for this job as we are a healthcare company committed to putting health and safety first for our members, patients, associates and the communities we serve. If progressed to offer, you will be required to provide proof of full vaccination or documentation for a medical or religious exemption consideration where allowed by law.
Scheduled Weekly Hours
40

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