Remote Operations management Jobs · Medicaid

• Lead our Eligibility team to ensure our participants maintain eligibility for PACE services.
• Proactively identify and mitigate risks pertaining to participant eligibility.
• Oversee participant demographic, eligibility and enrollment data integrity across Welbe systems.

WelbeHealth's interdisciplinary team provides all-inclusive care to vulnerable seniors. The company is rapidly expanding and has an encouraging and loving environment where every person feels uniquely cared for.

• Submit, track, and manage all Community Supports, Enhanced Care Management and Community Health Worker authorizations/reauthorizations/referrals
• Update Athena with authorization information and For Community Supports: add members to the outreach assignment tracker and ensure compliance with the 24-hour assignment standard
• Ensure workflow alignment with referral/authorization processes and Conduct internal checks for compliance, quality assurance, and clinical alignment

Zócalo Health is a tech-driven provider built specifically for Latinos, by Latinos, developing a new approach to care designed around shared and lived experiences. Founded in 2021, they are backed by leading healthcare and social impact investors, aiming to improve the lives of communities that have dealt with generations of poor experiences.

• Lead day-to-day census, enrollment, eligibility, and Medicaid re-eligibility operations.
• Develop, maintain, and enforce department policies, procedures, workflows, and monitoring routines.
• Supervise, mentor, and develop staff while setting clear expectations and maintaining accountability for performance and quality.

Habitat Health aims to help older adults experience an independent and joyful aging journey. They provide clinical and social care through the Program of All-Inclusive Care for the Elderly (“PACE”) in collaboration with healthcare partners like Kaiser Permanente.