Sobre este puesto de Supervisor, Medicare/Medicaid Eligibility en WelbeHealth
Candidates must be residing in the State of CA due to occasional travel that would be required to WelbeHealth PACE Centers.
Internal Title: Supervisor, Eligibility & Coverage
At WelbeHealth, we serve our communities’ most vulnerable seniors through shared intention, pioneering spirit, and the courage to love. These core values and our participant-focus lead the way no matter what.
The Supervisor, Eligibility & Coverage is accountable for oversight of eligibility process operations. This role will guide day-to-day priorities to lead a highly proactive Eligibility team. The Supervisor, Eligibility & Coverage leads with a data-driven approach to ensure continuous eligibility for our participants.
This role is different because Supervisor, Eligibility & Coverage at WelbeHealth:
- Plays a mission-driven leadership role, guiding seniors and their families through the enrollment journey and ensuring them access to compassionate, community-based care that helps them age with dignity and independence
- Lead the coordination of participant benefits within the uniquely integrated PACE care model, working closely with interdisciplinary teams to ensure coverage supports holistic care, creating a rewarding opportunity to impact how seniors experience healthcare every day
We care about our team members. That’s why we offer:
- Medical insurance coverage (Medical, Dental, Vision)
- Work/life balance - We mean it! 17 days of personal time off (PTO), 12 holidays observed annually, and 6 sick days
- 401K savings + match
- Comprehensive compensation package including base pay and bonus
- And additional benefits!
On the day-to-day, you will:
- Manage the Eligibility Advocate team, ensuring effective participant eligibility maintenance, reinstatements, and enrollment processing across Medicaid (DHCS) and Medicare (CMS)
- Set priorities, caseloads, and workflow assignments for Eligibility Advocates and Coordinators
- Develop outreach strategies to proactively prevent coverage lapses
- Oversee enrollment and disenrollment processing with DHCS and CMS
- Manage direct reports including hiring, training, supervising, and mentoring
- Partner with Operations, Quality, and Enrollment team leaders to refine workflows, SOPs, and job aids
- Support implementation of new eligibility policies or regulatory changes, ensuring timely training and adoption
- Maintain and improve tracking tools (e.g., hold trackers, renewal logs, escalation dashboards)
Job requirements include:
- Associate’s degree in relevant field; additional relevant professional experience may be substituted
- Minimum of three (3) years of experience in Medicaid/Medicare eligibility or social services
- Minimum of one (1) year of experience working with governmental agencies
- Two (2) years of supervisory experience with demonstrated ability to mentor and develop team members
- Must have strong KPI Management
- Experience leading in a data-driven organization, leveraging reports and data to prioritize and manage people and projects
We are seeking a Supervisor, Eligibility & Coverage that ideally has experience leading eligibility teams for PACE organizations. If you’re ready to join a holistic care team that values both its participants and providers, we’d love to hear from you!
Compensation consists of base salary plus bonus. WelbeHealth offers a competitive total rewards package that includes a 401(k) match, comprehensive healthcare coverage, and a broad range of additional benefits. Actual compensation will be determined based on experience and relevant qualifications.
COVID-19 Vaccination Policy
At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all our employees and proof of vaccination, or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations.
Our Commitment to Diversity, Equity and Inclusion
At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.
Beware of Scams
Please ensure your application is being submitted through a WelbeHealth sponsored site only. Our emails will come from @welbehealth.com email addresses. You will never be asked to purchase your own employment equipment. You can report suspected scam activity to [email protected]
