Director of Member Services

Job Summary

A company is looking for a Director, Census & Member Services.

Key Responsibilities

• Set vision and standards for census, enrollment, eligibility, and member services
• Oversee day-to-day enrollment and eligibility operations, ensuring compliance and accuracy
• Lead a high-performing team and manage operational performance, including KPIs and audits

Required Qualifications

• 8+ years of experience in health insurance operations with at least 2 years in a leadership role
• Expertise in Medicaid and Medicare eligibility, including Medicaid re-eligibility processes
• Background in capitated health plan financials; PACE experience preferred
• Bachelor's degree in healthcare, finance, or related field required; Master's degree preferred
• Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint)