Manager, Census & Member Services
Habitat Health
full-time
Posted on:
Location Type: Remote
Location: United States
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Salary
💰 $100,000 - $123,000 per year
About the role
- Lead day-to-day census, enrollment, eligibility, and Medicaid re-eligibility operations, ensuring all transactions are timely, accurate, and fully compliant.
- Develop, maintain, and enforce department policies, procedures, workflows, and monitoring routines, ensuring adherence by internal teams and external vendors.
- Produce and report operational metrics, audit findings, enrollment accuracy, and KPIs, identifying risks and driving timely remediation.
- Supervise, mentor, and develop staff while setting clear expectations and maintaining accountability for performance and quality.
- Serve as liaison with internal and external stakeholders to resolve escalated eligibility and enrollment discrepancies and ensure seamless coverage.
- Oversee membership maintenance across systems, including reconciliations, CMS interactions, and Medicare/Medicaid coordination of benefits.
- Own creation and maintenance of member correspondence and fulfillment materials in alignment with CMS guidance and plan policy.
- Identify and drive continuous improvement initiatives to enhance efficiency, accuracy, and participant experience.
Requirements
- 7+ years of experience in health insurance operations, including team leadership and direct supervisory experience.
- Demonstrated expertise in Medicaid and Medicare eligibility, with specific experience overseeing Medicaid re-eligibility processes.
- Background in capitated health plan financials; PACE experience strongly preferred.
- 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).
Benefits
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Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
Medicaid eligibilityMedicare eligibilitycensus operationsenrollment operationsaudit findingsoperational metricsKPI reportingcontinuous improvement initiativesfinancials in capitated health plansMedicaid re-eligibility processes
Soft Skills
team leadershipsupervisory experiencecustomer service orientationverbal communicationwritten communicationmentoringaccountabilitystakeholder liaisonproblem resolutionconfidential information handling