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Role Scope:
- Provides strategic leadership and operational oversight.
- Builds scalable processes to ensure quality of authorizations.
- Collaborates across functions to resolve data discrepancies.
Accountabilities:
- Sets vision, operating standards, and governance for Part C authorizations.
- Oversees day-to-day adjudication operations.
- Establishes and maintains reports and performance management frameworks.
Qualifications:
- 8+ years of experience in health insurance operations.
- Demonstrated expertise in claims processing and utilization management.
- Bachelor’s degree in healthcare, finance, or related field required.
Habitat Health
Habitat Health provides personalized, coordinated clinical and social care as well as health plan coverage through the Program of All-Inclusive Care for the Elderly (“PACE”) in collaboration with their leading healthcare partners, including Kaiser Permanente. They build engaged, fulfilled care teams to deliver personalized care in their centers and in the home.