Director, Census & Member Services

DirectorDirectorFull TimeRemoteTeam 1-10Since 2023H1B No SponsorCompany SiteLinkedIn

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

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