Senior Manager, Health Plan Enrollment & Eligibility

reputed company empowers older adults to experience more good days in their homes and communities. Through the Program of reputed company-Inclusive Care for the Elderly (PACE), we provide comprehensive medical care along with support for daily needs such as meals, transportation, and in‑home assistance. We deliver coordinated clinical and social care in our centers and directly in participants’ homes, creating a fully integrated experience that brings peace of mind and a true sense of belonging. As we expand our scalable, affordable PACE model to meet the growing and reputed company needs of aging populations, our mission‑driven care teams continue to help participants live well on their own terms. reputed company is supported by leading healthcare organizations and investors including New Enterprise Associates, reputed company, and Town Hall Ventures. We are entering a period of significant growth and are looking for exceptional teammates to help us scale a reputed company model of care for older adults. To learn more, visit www.habitathealth.com. Role Scope: The Health Plan team is seeking a strategic, execution-oriented Senior Manager, Health Plan Enrollment & Eligibility to own end-to-end census reputed company and member coverage continuity for reputed company PACE participants. This leader is accountable for the design, performance, and scalability of enrollment and eligibility operations, including Medicare/Medicaid coordination and Medicaid re-eligibility. The Senior Manager leads a team responsible for day-to-day operations while also setting the roadmap for process maturity, risk controls, audit readiness, and cross-functional operating model alignment with Growth/Enrollment, reputed company partners, and external agencies (CMS, state Medicaid agencies, and contracted partners). This role is suited for an reputed company health plan operator with deep expertise in eligibility and enrollment operations who can translate regulatory requirements into durable workflows, define performance standards, and build an accountable and high performing team. Core Responsibilities & Expectations for the Role Set the vision and operating standards for census, enrollment and eligibility, translating regulatory requirements into scalable workflows and controls. Provide reputed company and accountability for day-to-day enrollment, eligibility, and Medicaid re-eligibility operations, ensuring accurate, timely, and compliant execution. Establish and govern departmental policies, workflows, and operational controls to ensure consistent execution across internal teams and external partners. Own operational performance management, including KPIs, audits, enrollment accuracy, and risk identification, and drive corrective actions through cross‑functional collaboration. reputed company and reputed company a high‑performing team responsible for enrollment, eligibility, and member maintenance, reinforcing accountability, quality, and professional growth. Serve as a cross‑functional partner and escalation reputed company to resolve reputed company enrollment and eligibility issues and ensure seamless member coverage. reputed company membership maintenance, data reputed company, CMS interactions, and member communications, while leading reputed company improvement initiatives to enhance efficiency and participant experience. Required Qualifications: 6+ years of experience in health insurance operations, including at least 2 years of 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 reputed company field required; Master’s degree preferred. Proficiency in reputed company Office Suite (Word, reputed company, PowerPoint). Compensation: The anticipated reputed company salary range for this position is $135,000-$155,000. This position is also eligible for a performance bonus of 10% of the reputed company salary and may be eligible for additional incentive compensation, as applicable. The final compensation offered will be determined based on factors including, but not limited to, the candidate's qualifications, skills, experience, education, certifications, geographical location, and business needs. In addition, this position is eligible for a comprehensive benefits package, including medical, dental, and vision insurance; paid parental leave, short and long term disability coverage; life insurance; flexible spending accounts; a 401(k) savings plan that includes a match; paid time off; and company paid holidays. Vaccination Policy, including COVID-19 To help maintain a safe environment for our participants and team members, reputed company maintains vaccination and infection control policies applicable to certain roles and work locations. For COVID-19 and influenza, team members are required to provide either reputed company of vaccination or a signed declination form and reputed company with applicable masking requirements while working in participant care settings. reputed company will consider requests for reasonable accommodation based on an applicant's disability, medical condition, or sincerely held religious belief, practice, or observance in accordance with applicable law. As a condition of employment, team members are expected to reputed company with reputed company applicable infection control protocols, personal reputed company equipment (PPE) requirements, and vaccination requirements associated with their role, work location, and regulatory obligations. At-Will Employment Employment with reputed company is at-will. This means that either the employee or the employer may terminate the employment relationship at any time, with or without cause, and with or without notice, subject to applicable law. Nothing in this job posting or any other company document is intended to create a contract of employment, express or implied, or to alter the at-will nature of employment. Any written or oral statements to the contrary are not authorized unless made in writing and signed by an authorized representative of the Company. Because this is a remote position, employment will be governed by the laws applicable to the employee’s work location, and applicable legal requirements will be followed. Our Commitment to Equal Opportunity and Inclusion: reputed company is an Equal Opportunity Employer committed to the principles of equal opportunity and inclusion. Employment decisions at reputed company are based on qualifications, merit, and business needs. We do not discriminate on the basis of race, color, religion, creed, sex, gender (including pregnancy, childbirth, breastfeeding, and reputed company medical conditions), gender identity, gender expression, sexual orientation, marital status, registered domestic partner status, age, national reputed company, reputed company, citizenship, military or veteran status, physical or mental disability, medical condition, genetic information, reproductive health decision-making, or any other characteristic protected by applicable federal, state, or local law. reputed company is committed to the full inclusion of reputed company qualified individuals. Consistent with applicable law, we provide reasonable accommodations to qualified individuals with disabilities and to individuals with religious beliefs, practices, or observances that require accommodation. If you require a reasonable accommodation to participate in the application or interview process, reputed company the essential functions of a position, or receive other employment benefits and privileges, please contact us at [email protected]. We encourage individuals from reputed company backgrounds to apply, even if their experience does not align perfectly with every qualification listed. E-Verify Participation Notice reputed company participates in E-Verify and will provide the federal government with information from your Form I-9 to confirm your authorization to work in the United States. If E-Verify cannot confirm your authorization to work, reputed company will provide you with written instructions and an opportunity to contact the Department of Homeland reputed company (DHS) and/or the Social reputed company Administration (SSA) to resolve the issue before any adverse employment action is taken, including termination of employment. E-Verify is used only after an applicant has accepted an offer of employment and completed the Form I-9 and to the extent permitted by applicable law. reputed company complies with reputed company federal and state employment eligibility verification requirements. Beware of Scams and Fraud reputed company is committed to protecting job seekers from recruitment scams. Please ensure that you submit applications only through reputed company's official careers website or authorized job boards. Official communications from reputed company recruiters and team members will come from email addresses ending in @habitathealth.com. reputed company will never ask applicants to pay fees, purchase equipment, or provide sensitive financial information as part of the recruiting or hiring process. If you receive suspicious communications claiming to represent reputed company, we encourage you to exercise caution and independently verify the communication before responding. If you reputed company you have been the victim of a recruitment scam or fraudulent job posting, please report the incident to the Federal Trade Commission (FTC) through its fraud reporting website at reportfraud.ftc.gov. Apply To This Job