Manager, Census & Member Services

Habitat Health

9d • $100,000 - $123,000

About The Position

At Habitat Health, we envision a world where older adults experience an independent and joyful aging journey in the comfort of their homes, enabled by access to comprehensive health care. 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 our leading healthcare partners, including Kaiser Permanente.
Habitat Health offers a fully integrated experience that brings more good days and a sense of belonging to participants and their caregivers. We build engaged, fulfilled care teams to deliver personalized care in our centers and in the home. And we support our partners with scalable solutions to meet the health care needs and costs of aging populations.
Habitat Health is growing, and we’re looking for new team members who wish to join our mission of redefining aging in place. To learn more, visit https://www.habitathealth.com.
Role Scope:
Our Health Plan is looking for a driven, detail oriented, self-starter to lead a team responsible for ensuring seamless continuity of insurance coverage for all PACE participants. This leader oversees daily operations, manages direct reports, and serves as the primary point of contact for complex insurance matters, including Medicare / Medicaid re-eligibility and end to end census management. The manager collaborates closely with the Growth / Enrollment team, the Interdisciplinary Team (IDT), and external partners such as Medicare, state Medicaid agencies, and contracted providers. This job opportunity is suited for an individual with a background in core health plan enrollment and eligibility processing operations, core claims and enrollment operations and / or other core health plan functions.

Requirements

• 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.
• Background in capitated health plan financials; PACE experience strongly preferred.
• 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; Master’s degree preferred.
• Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint).

Nice To Haves

• Background in capitated health plan financials; PACE experience strongly preferred.
• Master’s degree preferred.

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.

Benefits

• This role is eligible for health insurance, life insurance, participation in the company’s equity program, and paid time off, including vacation and sick leave.

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Number of Employees: 11-50 employees