Senior Director, New Client Development
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Senior Director, Eligibility Excellence
WelbeHealth
full-time
Posted on:
Location Type: Remote
Location: Remote • California • 🇺🇸 United States
Visit company websiteSalary
💰 $168,895 - $232,231 per year
Job Level
Senior
About the role
- Lead the strategic design and execution of a scalable Eligibility Center of Excellence (CoE), including policy oversight, program segmentation, and end-to-end operational workflows across WelbeHealth’s national footprint
- Direct all day-to-day eligibility operations and performance, including redetermination processing, share of cost oversight and reporting, financial assistance consulting, reconciliation, and participant communications - all with direct accountability for timeliness, accuracy, and compliance
- Establish and manage KPIs, dashboards, and audit routines to track performance, monitor regulatory risk, and drive improvement across eligibility operations
- Build and lead a high-performing team, including managers and front-line staff responsible for hiring, training, coaching, and developing talent to consistently meet organizational goals
- Serve as the executive escalation point for complex eligibility cases and barriers, collaborating with cross-functional leaders to resolve risks and maintain access for participants, while building strong relationships with regulatory partners and advocacy agencies
- Manage cross-functional partnerships with internal teams such as Enrollment, Finance, Operations, and Compliance, to resolve barriers and ensure participants can access and sustain coverage in a timely, compliant, and seamless manner
- Drive enterprise-wide enablement, including internal training, SOPs, and knowledge base management
Requirements
- Bachelor’s degree required; master’s degree in public health, health administration, public policy, or related field preferred
- Minimum of ten (10) years of experience in California state Medicaid and Medicare eligibility, enrollment operations, health plan administration, or regulatory policy in managed care, state programs, or integrated provider systems
- Proven experience operating in regulated healthcare environments with direct responsibility for eligibility strategy, policy interpretation, and program execution
- Minimum of five (5) years of leadership experience managing large or multi-state eligibility teams or enterprise-level platforms, with demonstrated success in meeting performance, access, and compliance goals
- Strong command of federal and state Medicaid policy, including SOC, asset testing, redetermination, institutional deeming, and dual eligibility pathways
- Must be willing and able to work a varied schedule that may include evenings, weekends, and overtime
Benefits
- Medical insurance coverage (Medical, Dental, Vision)
- Work/life balance - We mean it! 17 days of personal time off (PTO), 12 holidays observed annually, and 6 sick days
- 401K savings + match
- Comprehensive compensation package including base pay, bonus, and equity
- And additional benefits!
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
eligibility operationsprogram segmentationKPI managementaudit routinesfinancial assistance consultingredetermination processingcompliance oversightpolicy interpretationhealth plan administrationmanaged care
Soft skills
leadershipteam buildingcoachingrelationship managementcross-functional collaborationcommunicationproblem-solvingstrategic designorganizational skillsperformance improvement
Certifications
Bachelor's degreeMaster's degree in public healthMaster's degree in health administrationMaster's degree in public policy
