Eligibility Operations Manager at Jobgether – United States

This position is posted by Jobgether on behalf of a partner company. We are currently looking for an Eligibility Operations Manager in United States.

The Eligibility Operations Manager will oversee the end-to-end partner onboarding experience, ensuring accuracy, efficiency, and alignment with business objectives. This role serves as a key liaison between technical and business teams, mapping member workflows and implementing solutions that optimize customer experience. You will collaborate across multiple functions including Sales, Product, Engineering, and Clinical Operations to deliver seamless eligibility processes and ensure high-quality implementations. The position requires proactive problem-solving, strategic thinking, and the ability to manage complex projects in a fast-paced, dynamic environment. Your work will directly impact operational success, member satisfaction, and overall health outcomes at scale.

• Lead and manage client eligibility file setup, ongoing monitoring, and accuracy, including file processing and issue resolution.

• Own client QA processes to ensure accurate and timely launches.

• Document client business requirements and act as a liaison with internal and external technical teams.

• Facilitate client discussions regarding data integrations, configuration requirements, member workflows, and benefit design during pre-sales and implementation.

• Identify and escalate risks to successful implementation, proactively addressing bottlenecks to maintain project timelines.

• Collaborate cross-functionally with Sales, Product, Engineering, Clinical Operations, Support, Revenue Cycle, and Analytics teams to optimize onboarding and operations.

• Drive continuous process improvements to enhance efficiency, accuracy, and partner satisfaction.

Requirements:

• 8+ years of experience in analytics, implementation, client services, or operations in healthcare services or technology.

• Strong verbal and written communication skills, capable of synthesizing complex information for technical and non-technical stakeholders.

• Proven problem-solving skills with the ability to identify root causes and implement effective solutions.

• Knowledge of eligibility file import ETLs and healthcare file formats such as 834 or HL7.

• Experience with MySQL or PostgreSQL databases.

• Working knowledge of SSO technologies including SAML 2.0 and OAuth 2.0.

• Bachelor’s degree required; Master’s in Science, Technology, or Operations field preferred.

• Comfortable leading matrixed teams and managing complex, multi-stakeholder projects.

• Familiarity with Medicare, Medicaid, and Commercial health plan operations is highly desirable.

• Preferred but not required: startup experience or knowledge of telehealth and nutrition sectors.

Benefits:

• Competitive salary range: $130,000 – $160,000 USD per year, plus bonus opportunities.

• Remote-first, flexible work arrangements.

• Unlimited paid time off.

• Comprehensive healthcare coverage: medical, dental, and vision.

• 401k plan and performance bonuses.

• Access to registered dietitian sessions and wellness programs.

• Inclusive and collaborative work environment.