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Habitat Health

Habitat Health is a senior-focused healthcare company empowering older adults to enjoy more good days through personalized, comprehensive care. The company prov

Senior Manager, Health Plan Enrollment & Eligibility

Location

United States

Posted

2 days ago

Salary

$135K - $155K / year

Seniority

Lead

No structured requirement data.

Job Description

Senior Manager, Health Plan Enrollment & Eligibility

Habitat Health

Role Description The Health Plan team is seeking a strategic, execution-oriented Senior Manager, Health Plan Enrollment & Eligibility to own end-to-end census integrity and member coverage continuity for all 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, IDT partners, and external agencies (CMS, state Medicaid agencies, and contracted partners). This role is suited for an experienced 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 oversight 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. - Lead and develop 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 point to resolve complex enrollment and eligibility issues and ensure seamless member coverage. - Oversee membership maintenance, data integrity, CMS interactions, and member communications, while leading continuous improvement initiatives to enhance efficiency and participant experience. 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 related field required; Master’s degree preferred. - Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint). Requirements - The anticipated base salary range for this position is $135,000-$155,000. - This position is also eligible for a performance bonus of 10% of the base 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. Benefits - Comprehensive benefits package, including medical, dental, and vision insurance. - Paid parental leave. - Short and long term disability coverage. - Life insurance. - Flexible spending accounts. - 401(k) savings plan that includes a match. - Paid time off. - Company paid holidays.

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