Supervisor Enrollment & HICS Casework

Network Health's success is driven by our mission to enhance the life, health, and wellness of the people we serve. This commitment guides our decisions, including the talented individuals we bring onto our team.

The Supervisor, Enrollment & HICS Casework provides daily operational oversight of enrollment functions while ensuring Health Insurance Casework System (HICS) cases are documented accurately, timely, and in compliance with regulatory requirements. This role partners closely with internal teams, technical staff, vendors, and regulators to support effective and compliant enrollment operations.

Key responsibilities include hiring, performance management, workload prioritization, and project oversight. The Supervisor also serves as a departmental resource, supports the Manager as needed, represents the team in cross-functional initiatives, and provides coverage for emergent issues and occasional evening/weekend needs.

Location: Candidates must reside in the state of Wisconsin for consideration. This position is eligible to work at your home office (reliable internet is required), at our office in Brookfield or Menasha, or a combination of both in our hybrid workplace model.

Hours: 1.0 FTE, 40 hours per week, 8am-5pm Monday through Friday

Check out our 2024 Community Report to learn a little more about the difference our employees make in the communities we live and work in. As an employee, you will have the opportunity to work hard and have fun while getting paid to volunteer in your local neighborhood. You too, can be part of the team and making a difference. Apply to this position to learn more about our team.

Job Responsibilities:

• Demonstrate commitment and behavior aligned with the philosophy, mission, values and vision of Network Health
• Appropriately apply all organizational and regulatory principles, procedures, requirements, regulations, and policies
• Demonstrate commitment and behavior aligned with Network Health's philosophy, mission, vision, and values.
• Supervise daily enrollment operations, including coaching, development, and performance management of team members.
• Maintain current knowledge of state, federal, regulatory, and industry service standards.
• Distribute and prioritize team workload to ensure timely and accurate processing.
• Ensure compliance with established desk procedures and regulatory requirements.
• Analyze and interpret reports, data feeds, and system downloads to monitor performance and accuracy.
• Safeguard member data integrity across all core systems and databases.
• Identify, track, and report errors; present and implement process improvements to reduce discrepancies.
• Research and resolve complex eligibility, enrollment, and termination issues, serving as liaison between Network Health, government agencies, and vendors.
• Serve as the primary point of contact for Health Insurance Casework System (HICS) cases, ensuring timely, accurate, and appropriate responses.
• Monitor Service Level Agreements (SLAs) and Key Performance Indicators (KPIs), identifying trends and escalating concerns as needed.
• Collaborate with vendors and internal teams to determine root causes and implement corrective action plans.
• Represent the team during internal and external audits; partner with Audit and Compliance to monitor and implement best practices.
• Review regulatory memos, call letters, and legislative updates to assess operational impact and implement necessary process changes.
• Attend relevant meetings, document key discussions, and track action items and follow-ups.
• Develop and update policies and desk procedures as needed.
• Perform additional duties and special projects as assigned.

Job Requirements:

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  Associate's degree or equivalent work experience required. Bachelor's degree preferred

  
  
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  Minimum of one (1) year of leadership experience required

  
  
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  Minimum of three (3) years of combined Medicare and/or Health Insurance Exchange experience required, preferably in member data analysis, reconciliation, compliance, or enrollment

  
  
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  Experience with CMS enrollment processes, regulations, and databases preferred

  
  

This combination of education and experience ensures the ability to effectively lead teams while navigating the regulatory and operational complexities of Medicare and Exchange enrollment.