Director of Eligibility Operations

Liviniti

Director of Eligibility Operations managing eligibility functions and product roadmaps at Liviniti. Leading technology integration and operational performance during platform migrations.

Posted 7/15/2026full-timeChicago • Illinois • 🇺🇸 United StatesLeadWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates extensive expertise in healthcare eligibility and EDI operations, with a strong focus on product roadmap ownership, strategic oversight, and cross-functional leadership. Proficient in managing platform migrations and leveraging automation to enhance operational efficiency.

Highest-signal resume keywords

Healthcare Eligibility ExpertiseX12 834 and 270/271 Transaction SetsSQL ProficiencyEligibility Function LeadershipCross-Functional Communication

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Eligibility Product Roadmap OwnershipBenefit-Level Configuration OversightVendor Integration StrategyAutomation and AI Workflow IdentificationPlatform Migration ManagementTesting Sign-OffMigration ValidationPost-Go-Live StabilityTroubleshooting ExperienceOperational Continuity Management

Soft Skills

Strong CommunicationInfluential Leadership

Tools & Technologies

SQLSnowflakeDashboardsReporting Tools

Industry Keywords

EDI OperationsPBMHealth Plan Benefit Administration

Tech Stack

Tools & technologies

CloudSQL

About the role

Key responsibilities & impact

Own the eligibility product roadmap, annual planning, and enhancement prioritization.
Translate client and operational requirements into development-ready specifications.
Own benefit-level configuration oversight and vendor integration strategy.
Identify automation and AI-assisted workflow opportunities within the eligibility function.
Own the eligibility function's contribution to platform migration initiatives, including testing sign-off, migration validation, and post-go-live stability.
Keep the team's work visible to leadership through dashboards, reporting, or equivalent tools.
Provide strategic oversight to the EDI/Eligibility Manager and maintain ultimate accountability for team performance and quality.
Represent the eligibility function in client conversations and cross-functional leadership discussions.

Requirements

What you’ll need

10 or more years in healthcare eligibility, EDI operations, or PBM/health plan benefit administration.
Expert knowledge of X12 834 and 270/271 transaction sets with hands-on troubleshooting experience.
Working SQL proficiency and familiarity with Snowflake or comparable cloud data platforms.
Demonstrated experience owning or leading an eligibility or EDI function at a senior level.
Experience managing operational continuity through active platform migrations or system transitions.
Proven ability to lead through influence and own a product roadmap.
Strong communicator across technical and non-technical stakeholders, including clients and executives.

Benefits

Comp & perks

Medical, Dental Vision insurance
Disability and Life insurance
Employee Assistance Program
Remote work options
Annual Reviews and Development Plans
Retirement Plan with company match immediately 100% vested.