WelbeHealth · 1 day ago
Manager, Eligibility
United States
Full-time
Remote
Mid, Senior Level
$109K/yr - $144K/yr
5+ years expWelbeHealth is dedicated to providing all-inclusive care to vulnerable seniors, and they are seeking a Manager, Eligibility to oversee Medicaid and Medicare coverage maintenance. The role involves ensuring data accuracy and integrity while leading a team to maintain participant eligibility and compliance with regulatory standards.
Health CareHealth DiagnosticsHospital
Responsibilities
Lead our Eligibility team to ensure our participants maintain eligibility for PACE services through proactive management including but not limited to establishing strategies, tools and management processes that prevent eligibility discrepancies
Leverage advanced data analytics and a deep understanding of regulatory requirements, to proactively identify and mitigate risks pertaining to participant eligibility; ensure reporting accuracy by supervising the verification of eligibility data in key reports, such as encounter and prescription drug event reporting
Oversee participant demographic, eligibility and enrollment data integrity across Welbe systems
Monitor revenue impact by directing the analysis of eligibility data, identifying potential financial risks, and ensuring that these risks and outcomes are communicated to finance teams and local programs
Effectively communicate risks and outcomes to key stakeholders while engaging in a collaborative process that transforms complex data into actionable insights that result in timely decision-making
Coordinate with local market leaders by directing efforts to identify and prioritize high impact discrepancies, ensuring the team executes corrective actions efficiently and effectively
Liaise with county and state agencies and other governmental agencies to verify continuous eligibility for Welbe participants and ensuring participants’ Medicaid and Medicare coverage is correctly attributed
Qualification
Required
Bachelor's Degree in relevant field preferred
Minimum of five (5) years' experience working in healthcare or social services administration is required
Minimum of three (3) years of experience interacting with local government Medicaid or Social Security agencies required
Minimum of one (1) year of experience working with Medicare eligibility and Center for Medicare and Medicaid Services
Two (2) years' supervisory experience with demonstrated ability to mentor and develop team members
Experience leading in a data-driven organization, leveraging reports and data to prioritize and manage people and projects
Preferred
Experience working in a larger scale company environment is highly desired
Benefits
Health Coverage on Day 1
Paid Parental Leave
401K Match
17 days of paid time off in year one
12 company holidays
6 sick days
Company
WelbeHealth
Unlocking the full potential of our most vulnerable seniors with empathy and love.
501-1000 employees
Funding
Current Stage
Late StageTotal Funding
$61.23M2020-02-10Series C· $30M
2018-06-29Series B· $15M
2017-02-08Series A· $15M
Leadership Team
Si France
Founder & CEO
Becca Miller Rose
Chief Operating Officer
Recent News
2025-09-02
2025-07-08
2025-06-27
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