Habitat Health · 7 hours ago
Manager, Census & Member Services
United States
Full-time
Remote
Mid, Senior Level
$100K/yr - $123K/yr
7+ years expHabitat Health envisions a world where older adults experience an independent and joyful aging journey, and they are seeking a Manager for Census & Member Services. This role involves leading a team to ensure seamless continuity of insurance coverage for PACE participants, overseeing daily operations, and collaborating with various stakeholders to manage eligibility and enrollment processes.
Health CareMedicalNutritionPersonal Health
Responsibilities
Lead day-to-day census, enrollment, eligibility, and Medicaid re-eligibility operations, ensuring all transactions are timely, accurate, and fully compliant
Develop, maintain, and enforce department policies, procedures, workflows, and monitoring routines, ensuring adherence by internal teams and external vendors
Produce and report operational metrics, audit findings, enrollment accuracy, and KPIs, identifying risks and driving timely remediation
Supervise, mentor, and develop staff while setting clear expectations and maintaining accountability for performance and quality
Serve as liaison with internal and external stakeholders to resolve escalated eligibility and enrollment discrepancies and ensure seamless coverage
Oversee membership maintenance across systems, including reconciliations, CMS interactions, and Medicare/Medicaid coordination of benefits
Own creation and maintenance of member correspondence and fulfillment materials in alignment with CMS guidance and plan policy
Identify and drive continuous improvement initiatives to enhance efficiency, accuracy, and participant experience
Qualification
Required
7+ years of experience in health insurance operations, including team leadership and direct supervisory experience
Demonstrated expertise in Medicaid and Medicare eligibility, with specific experience overseeing Medicaid re-eligibility processes
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
Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint)
Preferred
Background in capitated health plan financials; PACE experience strongly preferred
Master's degree preferred
Benefits
Health insurance
Life insurance
Participation in the company’s equity program
Paid time off, including vacation and sick leave
Company
Habitat Health
Habitat Health provides health and social care to older persons with medical services.
51-200 employees
Funding
Current Stage
Growth StageTotal Funding
$50M2024-04-09Series Unknown· $50M
Recent News
Modern Healthcare
2025-02-15
Modern Healthcare
2025-01-03
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