Senior Manager, Health Plan Enrollment & Eligibility

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Habitat HealthHealthcare, Health Insurance

Because this is a remote position, employment will be governed by the laws applicable to the employee’s work locationFull-TimeManager

Salary$135,000-$155,000

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Job Details

Experience: 6+ years of experience in health insurance operations, including at least 2 years of team leadership and direct supervisory experience
Required Skills: Microsoft ExcelComplianceMicrosoft Office Suite

6+ years of experience in health insurance operations.
At least 2 years of team leadership and direct supervisory experience.
Demonstrated expertise in Medicaid and Medicare eligibility, including Medicaid re-eligibility processes.
Background in capitated health plan financials.
Strong customer service orientation and ability to handle confidential information.
Excellent verbal and written communication skills.
Bachelor’s degree in healthcare, finance, or related field required; Master’s degree preferred.
Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint).
PACE experience strongly preferred.

Set the vision and operating standards for census, enrollment, and eligibility, translating regulatory requirements into scalable workflows and controls.
Provide oversight and accountability for day-to-day enrollment, eligibility, and Medicaid re-eligibility operations.
Establish and govern departmental policies, workflows, and operational controls to ensure consistent execution.
Manage operational performance, including KPIs, audits, and risk identification, driving corrective actions.
Lead and develop a high-performing team, reinforcing accountability, quality, and professional growth.
Serve as a cross-functional partner to resolve complex enrollment and eligibility issues.
Oversee membership maintenance, data integrity, CMS interactions, and member communications.

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