Supervisor, Enrollment Quality Assurance

Job description

Founded in 1977 as the Senior Care Action Network, SCAN began with a simple but radical idea: that older adults deserve to stay healthy and independent. That belief was championed by a group of community activists we still honor today as the “12 Angry Seniors.” Their mission continues to guide everything we do. Today, SCAN is a nonprofit health organization serving more than 500,000 people across Arizona, California, Nevada, New Mexico, Texas, and Washington, with over $8 billion in annual revenue. With nearly five decades of experience, we have built a distinctive, values-driven platform dedicated to improving care for older adults. Our work spans Medicare Advantage, fully integrated care models, primary care, care for the most medically and socially complex populations, and next-generation care delivery models. Across all of this, we are united by a shared commitment: combining compassion with discipline, innovation with stewardship, and growth with integrity. At SCAN, we believe scale should strengthen—not dilute—our mission. We are building the future of care for older adults, grounded in purpose, accountability, and respect for the people and communities we serve. The Job The Supervisor, Enrollment Quality Assurance (QA) is responsible for the day-to-day supervision of the enrollment reconciliation and operations specialist staff and the activities related to Medicare health plan members and employer groups. You Will Oversee data workflows and daily enrollment reconciliation and operations specialist tasks to ensure timely and accurate outcomes Maintains professional and technical knowledge by attending educational workshops, reviewing professional publications, establishing personal networks, participating in professional societies. Monitors the work between cross-functional departments by coordinating support to Enrollment and Reconciliation (E&R) and Grievance and Appeals (GAD) departments Contributes to team effort by accomplishing related results as needed. Improves processes by evaluating existing membership and payment reconciliation data workflows and offering suggestions to Management on implementation or monitoring guidelines for software programs to ensure optimum reconciliation revenue is captured. Trains staff and monitors work to ensure operations are at the level necessary to meet established guidelines and regulatory requirements Oversees workflow, assigns work responsibilities and tasks, and prioritizes deliverables in order to meet department goals and objectives. Fields escalated issues and non-routine questions, providing guidance and direction to team. Keeps abreast of changes to legislation and regulations which pertain to health insurance procedures. Oversees the preparation of reports by collecting, analyzing, and summarizing information and trends; recommends courses of action to management. Facilitates and works with management team to fulfill audit requests as needed. Maintains staff job results by coaching, counseling, and disciplining employees; planning, monitoring and appraising job results. Supervises/Manages Others (i.e. hires, performance reviews, corrective action, etc.). We seek Rebels who are curious about AI and its power to transform how we operate and serve our members. Actively support the achievement of SCAN’s Vision and Goals. Other duties as assigned. Your Qualifications Bachelor's or Technical Degree or equivalent experience required. 3+ years of experience in enrollment and reconciliation experience in the Health Care or Health Plan industry. Demonstrated supervisory experience. Experience in Medicare Advantage is highly preferred. Leadership - Basic skills to develops others. Problem Solving - Basic problem solving skills. Communication - Good written and verbal communication and interpersonal skills. Microsoft Office (Word, Excel, PowerPoint, Outlook, Teams) at advanced level is required. What's in it for you? Base salary range: $71,700 to $103,732 per year Internal title: Sup Recon & Ops Work Mode: Mostly Onsite An annual employee bonus program Robust Wellness Program Generous paid-time-off (PTO) Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday Excellent 401(k) Retirement Saving Plan with employer match and contribution Robust employee recognition program Tuition reimbursement An opportunity to become part of a team that makes a difference to our members and our community every day! We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now! At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more. SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required. #LI-MS1 #LI-Hybrid Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)