PEHP Health & Benefits is a division of the Utah Retirement Systems that proudly serves Utah’s public employees through high quality and competitively priced medical, dental, life, and long-term disability insurance plans on a self-funded basis. As a government entity, we embrace both a public mission and a commitment to creating customer value, excelling in the market, and improving healthcare.   We offer a competitive salary with generous benefits, personal development in a positive team environment, and excellent work-life balance. 

For most jobs, remote work is available for 9 out of every 10 workdays.

POSITION SUMMARY

The Enrollment Supervisor position plays a critical role in PEHP’s efforts to serve and create value by ensuring that members, employer groups, and brokers are being treated with respect and given accurate information. The Enrollment Supervisor will work directly with the Enrollment Manager, Enrollment Specialists, Administrative Systems Analysts, PEHP Marketing representatives, employer groups, and brokers to establish and maintain guidelines for enrollment processing. Performs a variety of technical first-line supervisory duties related to planning, organizing, directing, and controlling the day-to-day processing of the PEHP Enrollment Department. Successful performance for this position requires a thorough understanding of PEHP plans and enrollment guidelines. Has superior organization skills, strong communication and analytical skills, managing multiple diverse tasks, maintaining accurate and timely records, attention to detail, and a high level of commitment and dependability.

ESSENTIAL JOB FUNCTIONS AND DUTIES

1. Assists and makes recommendations in evaluating worker performance, job retention, advancement, discipline, discharge, and participates in the recruitment and selection process for new hires.
2. Acts as an advocate to proactively resolve insurance problems related to enrollment, Coordination of Benefits (COB), or other issues as required; research and report on escalated issues for Enrollment related calls, WAM messages, emails, and appeals.
3. Assists the Enrollment/Intake Manager in monitoring and coordinating the daily activities of the Enrollment Department.
4. Makes recommendations, implements, updates, maintains policies, and establishes guidelines and practices to enhance efficiency and effectiveness of the Enrollment Department. Documents Enrollment and COB processes and suggests and implements improvements when appropriate.
5. Coordinates with the Enrollment/Intake Manager and monitors the training procedures for all new hires. Assists with follow up training, evaluation, delegating assignments, coordinating special training, maintaining quality control, and assisting in setting goals and priorities for new and existing employees.
6. Monitors and reviews Enrollment related calls to verify and assure accuracy of the information given out. Monitors call volume, ensures timely handling of calls, and assists in allocating resources to meet the needs to internal and external customers. Monitors Enrollment work through audits, coaching, error reports, and any other process to assist in ensuring accuracy.
7. Prepares and/or generates various reports, reconciliations, summaries, and data feeds related to employee/group eligibility records, employer/employee cost-sharing, and employee payroll deductions. Verifies PEHP input transactions to ensure proper employer/employee contributions collection and will audit the State of Utah files and other reports for enrollment changes, eligibility, and termination dates.
8. Point of contact for new groups, escalated group issues, and participates in the implementation, set-up and testing of new groups and plans.
9. Handles and resolves complex Enrollment related calls. Recommends and implements procedures under the direction of the Enrollment/Intake Manager for measuring and verifying member satisfaction.
10. Services URS and PEHP employees in addressing questions regarding Enrollment requirements and status.
11. Reviews and make recommendations regarding training materials; directs the design, implementation, and maintenance of training manuals and other materials. Assist in developing and designing automated training modules for department employees, including text and graphical data and training videos; monitors policies and procedures changes and maintains enrollment manuals. Records meeting minutes and compiles them into a manual.
12. Coordinates the annual ACA reporting process and provides a point of contact for marketing and employer groups regarding ACA reporting. Pulls ACA reports to provide to marketing; files State ACA reports on behalf of the State of Utah, proactively contacts the appropriate parties to arrange timely printing and mailing of ACA forms to members. Handles the creation and distribution of the 1095/ACA reports from the PEHP system to any outbound files, reports, mailings, etc., to members and marketing.
13. Maintains regular and reliable attendance.
14. Maintains strict confidentiality.
15. Performs other related duties as required.

Education and Experience

High school diploma and four (4) years of progressively responsible experience performing administrative duties related to reporting, planning, and organizing and/or, supervisory duties (mentoring, training, employee supervision, or coaching); including two (2) years specific PEHP experience; or an equivalent combination of education and experience.

Specific experience in health insurance and coordination of benefits procedures is preferred

Knowledge, Skills, and Abilities

This list contains knowledge, skills, and abilities that are typically associated with the job. It is not all-inclusive and may vary from position to position:

Required technical skills include the working knowledge and ability of:

• Various office management systems related to alpha and numeric record keeping.
• Ten-key operation.
• Microsoft Office Suite skills.

Required mathematical skills include working knowledge of:

• Ability to calculate figures and amounts such as discounts, percentages, fractions, and ratios.

Required knowledge of:

• PEHP Enrollment processes, policies, and procedures including group specific rules.
• COB processes, policies, and procedures.
• Plan and policy set-up processes and procedures.
• ACA reporting processes and procedures.

Must possess excellent communication skills:

• Ability to read, analyze, and interpret general business periodicals, technical procedures, or regulations.
• Ability to write reports, business correspondence, and procedure manuals.
• Interpersonal communication skills and public relation skills.
• Present to new hires as well as in department meetings.
• Proper telephone etiquette.
• Customer service techniques.
• Training techniques.

Must have the ability to:

• Follow written and verbal instructions.
• Prioritize work.
• Perform within deadlines.
• Work well in a team environment as well as independently.
• Multi-task by handling a variety of duties in a timely and efficient manner.
• Follow through with assignments.
• Deal effectively with stress caused by workload and time deadlines.
• Supervise and motivate employees.

Work Environment

Incumbent performs in a typical office setting with appropriate climate controls. Tasks require a variety of physical activities which do not generally involve muscular strain, but do require activities related to walking, standing, stooping, sitting, reaching, talking, hearing and seeing. Common eye, hand, finger dexterity required to perform essential functions.