Director Membership Acctg

Health Net, Inc. (NYSE: HNT) is among the nation’s largest publicly traded managed health care companies. Health Net’s mission is to help people be healthy, secure and comfortable. The company’s POS, HMO, insured PPO, behavioral health and government contracts subsidiaries provide health benefits to more than 7 million individuals. For more information on Health Net, Inc., please visit the company’s Web site at www.healthnet.com

 

JOB SUMMARY:

 

The Director Membership Accounting directs staff to ensure accurate and responsive maintenance of the group and member databases for all lines of business (Commercial, ASO, Medicare and Medicaid).

 

ESSENTIAL DUTIES AND RESPONSIBILITIES: Manages, directs and coordinates membership activities through subordinate managers or supervisors for eligibility maintenance of both individual and group accounts for all lines of business (Commercial, ASO, Medicare, and Medicaid). Manages a mutually supportive business relationship with Accounting, Sales & Marketing and other key personnel to ensure smooth operational processes resulting in the delivery of high quality customer service. Interacts with external auditors, government agencies and others with respect to interim and annual audits relating to enrollment and eligibility. Analyzes cost effectiveness of all departmental programs; plans budgets and staffing levels. Develops and recommends policies and procedures according to company and departmental goals. Advises management of industry trends and legislative changes affecting membership programs. Acts as liaison to outside agencies, internal contacts and other department staff on membership issues. May manage efficient processing of COBRA, COB, disabled dependent, overage dependent and full time student eligibility or Manage payment/receipt of commission/administration fee arrangements concerning Brokers, COBRA, Self-Funded and other contractual obligations related to region products. Recruits, develops, and manages staff and the daily activities of these personnel in support of Health Net business objectives. Develops and manages processes that effect the workflow, accuracy and effectiveness of the Membership Accounting and eligibility processes for all lines of business. Accountable for achieving targeted or exceeding production and quality goals related to the Membership Accounting and eligibility processes. Initiates and leads interdepartmental committees as related to specific responsibilities of the job. Performs special projects as assigned. Assumes primary responsibility for “whole case.”

REQUIREMENTS:

 

Education:

Bachelor’s degree in Accounting, Business Administration, a related field, or the equivalent work experience required.

 

Certification/License:

 

Experience:

Five years experience in membership eligibility, billing and receivables within the HMO/health care industry required.

Five years management experience required.

Finance and/or accounting experience would be a plus.

 

Knowledge, Skills & Abilities: Excellent written and oral communication skills required. Ability to operate PC based office software required. Demonstrated ability to analyze, apply, interpret and communicate policies, procedures and regulations required.

OR
Any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position.

 

Health Net, Inc. supports a drug-free work environment and requires pre-employment background and drug screening.

 

Health Net and its subsidiaries are an Equal opportunity/Affirmative Action Employer M/F/V/D.