Manager, Eligibility
WelbeHealth
full-time
Posted on:
Location Type: Remote
Location: California • United States
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Salary
💰 $109,240 - $144,197 per year
About the role
- Lead our Eligibility team to ensure our participants maintain eligibility for PACE services through proactive management including but not limited to establishing strategies, tools and management processes that prevent eligibility discrepancies
- Leverage advanced data analytics and a deep understanding of regulatory requirements, to proactively identify and mitigate risks pertaining to participant eligibility; ensure reporting accuracy by supervising the verification of eligibility data in key reports, such as encounter and prescription drug event reporting
- Oversee participant demographic, eligibility and enrollment data integrity across Welbe systems
- Monitor revenue impact by directing the analysis of eligibility data, identifying potential financial risks, and ensuring that these risks and outcomes are communicated to finance teams and local programs
- Effectively communicate risks and outcomes to key stakeholders while engaging in a collaborative process that transforms complex data into actionable insights that result in timely decision-making
- Coordinate with local market leaders by directing efforts to identify and prioritize high impact discrepancies, ensuring the team executes corrective actions efficiently and effectively
- Liaise with county and state agencies and other governmental agencies to verify continuous eligibility for Welbe participants and ensuring participants’ Medicaid and Medicare coverage is correctly attributed.
Requirements
- Bachelor’s Degree in relevant field preferred
- Minimum of five (5) years’ experience working in healthcare or social services administration is required
- Minimum of three (3) years of experience interacting with local government Medicaid or Social Security agencies required
- Minimum of one (1) year of experience working with Medicare eligibility and Center for Medicare and Medicaid Services
- Two (2) years’ supervisory experience with demonstrated ability to mentor and develop team members
- Experience leading in a data-driven organization, leveraging reports and data to prioritize and manage people and projects
- Experience working in a larger scale company environment is highly desired.
Benefits
- Health Coverage on Day 1
- Paid Parental Leave
- 401K Match
- 17 days of paid time off in year one
- 12 company holidays
- 6 sick days
- Career path advancement and leadership opportunities
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
data analyticseligibility verificationfinancial risk analysisdata integrity managementreporting accuracyMedicaid eligibilityMedicare eligibilityCenter for Medicare and Medicaid Servicesstrategic planningcorrective action execution
Soft Skills
leadershipcommunicationcollaborationmentoringdecision-makingproblem-solvingteam managementstakeholder engagementorganizational skillsdata-driven prioritization