Operations Manager

Conduit Health

Operations Manager investigating insurance eligibility and coverage issues at Conduit Health. Collaborating with teams to enhance patient access to medical supplies and services.

Posted 7/24/2026full-timeNew York City • New York • 🇺🇸 United StatesMid-LevelSenior💰 $70,000 - $120,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in eligibility verification, prior authorization processes, and healthcare insurance operations, with a strong focus on Medicaid, Medicare, and commercial payer rules. Proven ability to develop SOPs, improve workflows, and analyze KPIs to drive operational efficiency.

Highest-signal resume keywords

Eligibility VerificationPrior Authorization ManagementMedicaid And Medicare KnowledgeSOP DevelopmentKPI Tracking And Reporting

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Eligibility VerificationPrior AuthorizationMedical BillingRCMDMEPOS ExperienceProcess ImprovementKPI Analysis

Soft Skills

Investigative MindsetCommunication SkillsCollaboration Skills

Tools & Technologies

AvailityEMedNYPayer PortalsEMR Systems

Industry Keywords

Healthcare Insurance OperationsCoverage PoliciesFee SchedulesDenial Management

About the role

Key responsibilities & impact

Investigate coverage and eligibility: Verify insurance, discover unknown or secondary coverage from patient demographics, and resolve mismatches between eligibility results and order routing.
Do the detective work: When an order is stuck, trace it to root cause - lapsed coverage, wrong plan, MCO carve-out, entity/NPI mismatch, documentation gaps - and drive it to resolution.
Own prior authorization: Submit, track, and follow up on prior auths and appeals; keep turnaround tight.
Work denials and rejections: Resolve them, identify the patterns behind them, and close the gaps that cause them.
Research payers: Maintain working knowledge of plan structures, coverage policies, and fee schedules across our active and expansion states.
Build the systems: Develop and maintain SOPs; turn recurring investigations into repeatable, ideally automated, workflows.
Track & report KPIs: Measure eligibility hit rate, auth turnaround, denial rate, and clean-order rate; prepare reports and surface insights to leadership.

Requirements

What you’ll need

3+ years in DME or healthcare insurance operations, eligibility/benefits verification, prior authorization, RCM, or medical billing.
Strong working knowledge of Medicaid, Medicare, and commercial payer rules; DMEPOS experience a strong plus.
Hands-on experience with eligibility and clearinghouse tools (e.g., Availity, eMedNY, payer portals) and EMR or order-ordering platforms.
An investigative mindset - you enjoy untangling messy, ambiguous problems and getting to the bottom of them.
Experience building SOPs and improving processes in a regulated environment.
Stellar communication and collaboration skills.

Benefits

Comp & perks

Competitive salary with performance-based incentives.
Flexible working environment (3 in-office days per week in New York).
Unlimited PTO + 9 company holidays.
Direct mentorship and growth opportunities with senior leadership.