Shaw has been in business for 75 years and is a subsidiary of Berkshire-Hathaway, offering 100% no-touch freight, 100% drop and hook on head haul, 100% outbound company freight, and world-class minimal downtime. Effective dispatching is a priority to maximize work and daily home time.
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Manages the day to day operations of the VNSNY CHOICE Membership and Eligibility Unit (MEU) functions related to enrollment and disenrollment activities, member premium billing/collections, and prescription drug event reconciliation activities for all VNSNY CHOICE Medicare product lines and the Fully Integrated Dual Advantage (FIDA) plan. Supervises Third Party Administrator (TPA) Enrollment/Reconciliation/Billing entities and Third Party vendors to ensure smooth transitions of data transfers. Monitors enrollment processing activities to ensure compliance to Center for Medicare and Medicaid Services (CMS) and State Department of Health (SDOH) guidelines and plan's enrollment contractual agreements. Develops and implements internal control procedures to ensure efficient performance of all membership and eligibility functions. Works under general direction. Education: Bachelor's Degree in Business Administration, Health Administration, or related discipline required. Master's degree in Business Administration or Health Administration preferred. Experience: Minimum five years direct supervision and management of staff, preferably in a health care environment required. Demonstrated knowledge of enrollment operations, with strong knowledge of Medicare and working knowledge of Medicaid. Has understanding of an effective and efficient reconciliation system and some knowledge of financial operations. Advanced proficiency with Excel, Access and Word software applications required. Effective oral, written and interpersonal communication skills required.
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