Director, Census & Member Services
Location
United States
Posted
30 days ago
Salary
$130K - $165K / year
Bachelor Degree8 yrs expEnglish
Job Description
• Own end-to-end census integrity and member coverage continuity for all PACE participants.
• Set the vision and operating standards for census, enrollment, eligibility, and member services.
• Provide oversight and accountability for day-to-day enrollment, eligibility, and Medicaid re-eligibility operations.
• Establish and govern departmental policies, workflows, and operational controls.
• Own operational performance management, including KPIs, audits, and risk identification.
• Lead and develop a high performing team responsible for enrollment and eligibility.
• Serve as a cross functional partner to resolve complex enrollment and eligibility issues.
• Oversee membership maintenance, data integrity, and member communications.
Job Requirements
- 8+ 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 related field required; Master’s degree preferred.
- Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint).
Benefits
- Health insurance
- Life insurance
- Participation in the company’s equity program
- Paid time off, including vacation and sick leave
Related Guides
Related Categories
Related Job Pages
More Director Jobs
Director30 days ago
Full TimeRemoteTeam 501-1,000H1B Sponsor
Scientific Director overseeing medical communications for pharmaceutical and biotech clients
United States
Senior Director of Business Solutions – Strategic Alliances
Workplace OptionsWellbeing solutions that drive positive outcomes for organizations while transforming people's lives for the better
Director30 days ago
Full TimeRemoteTeam 1,001-5,000Since 1982H1B No Sponsor
Sales Director leading reseller relationships in the wholesale market for Workplace Options
United States
Director30 days ago
Full TimeRemoteTeam 201-500Since 1913H1B No Sponsor
Development Director executing fundraising strategies for National Safety Council
Director, Palliative Care
VyncaCommitted to empowering individuals, their loved ones, and their care teams with solutions delivered in their homes.
Director30 days ago
Full TimeRemoteTeam 51-200Since 2014H1B No Sponsor
Director of Palliative Care managing interdisciplinary healthcare teams
Arizona + 9 moreAll locations: Arizona, California, Colorado, Florida, Illinois, Nevada, North Carolina, Oregon, Texas, Washington
$160K - $190K / year