Health Plan Associate, Program Management

Habitat Health; California (MO); Hybrid; USD 67,000 - 87,000; Full time

Benefits offered by this job

Medical, dental & vision

Parental leave

Disability coverage

Life insurance

Flexible spending accounts

401(k) with match

Paid time off

Company holidays

Job summary

Habitat Health is seeking a Health Plan Associate – Program Management to drive cross-functional initiatives across enrollment, authorizations, claims, and provider networks. You will lead projects, manage timelines, and ensure regulatory compliance while coordinating with internal teams and external partners.

The role focuses on scaling a PACE-inspired care model, with responsibilities spanning regulatory filings, data integrity, and go-live readiness for new centers.

Qualifications

• 2-4 years of project management experience in healthcare settings.
• Experience with Medicare/Medicaid systems is required.
• Excellent written and verbal communication with internal/external stakeholders.

Responsibilities

• Lead cross-functional Health Plan projects and process improvements.
• Manage end-to-end work plans for enrollment, authorizations, claims, and network performance.
• Develop schedules, milestones, and resource estimates with SMEs.
• Coordinate meetings and track outcomes against metrics like timeliness and compliance.
• Escalate barriers to Health Plan leadership as needed.

Skills

Project management

Healthcare/health plan experience

Communication skills

Regulatory awareness

Forecasting risks & solutions

Tools

SharePoint

Smartsheet

MS Office

Job description

Habitat Health empowers older adults to experience more good days in their homes and communities. Through the Program of All-Inclusive Care for the Elderly (PACE), we provide comprehensive medical care along with support for daily needs such as meals, transportation, and in‑home assistance. We deliver coordinated clinical and social care in our centers and directly in participants’ homes, creating a fully integrated experience that brings peace of mind and a true sense of belonging. As we expand our scalable, affordable PACE model to meet the growing and complex needs of aging populations, our mission‑driven care teams continue to help participants live well on their own terms. Habitat Health is supported by leading healthcare organizations and investors including New Enterprise Associates, Kaiser Permanente, and Town Hall Ventures. We are entering a period of significant growth and are looking for exceptional teammates to help us scale a better model of care for older adults. To learn more, visit www.habitathealth.com.

Role Scope

We are looking for a detail oriented, results driven individual who will drive assigned program outcomes from initiation to close-out in a defined timeframe. The Health Plan Associate – Program Management plays a central role in coordinating and monitoring cross-functional projects that span claims, authorizations, pharmacy (Part D), provider network, eligibility/census management, member services, and other Health Plan program management.

• Lead cross-functional healthcare projects, initiatives, and operational process improvements for the Health Plan function
• Drive projects and initiatives that cut across multiple domains (e.g., new vendor implementations, regulatory audits, process standardization, data integrity efforts) and maintain the end-to-end work plan for Health Plan operations — enrollment, authorizations, claims, pharmacy, and network performance — identifying risks, dependencies, and inefficiencies along the way.
• Develop and maintain project schedules, milestones, and resource/timeline estimates; partner with subject‑matter experts (e.g., Claims, Compliance, Provider Network, Data & Analytics) to document processes and design improvements aligned to regulatory and organizational goals.
• Coordinate and facilitate project meetings with internal stakeholders and external partners, and track outcomes against operational metrics (e.g., timeliness, accuracy, compliance adherence).
• Follow up with responsible parties to ensure timely completion of open items, correcting course when work goes beyond scope or off‑target, and escalating barriers to Health Plan leadership as needed.
• Own Health Plan regulatory processes and filings, ensuring strict adherence to critical timelines.
• Serve as the primary point of accountability for assigned regulatory filings, reporting submissions, and compliance deliverables, ensuring accuracy and on‑time completion.
• Maintain a master regulatory calendar of response windows, due dates, and filing deadlines, proactively flagging upcoming items well in advance of when they are due.
• Balance time‑sensitive regulatory obligations against day‑to‑day functions and ongoing projects, escalating potential conflicts early to protect critical due dates.
• Serve as the Health Plan lead for go‑live readiness on new center openings
• Represent the Health Plan function in go‑live planning and readiness activities, ensuring Health Plan requirements, systems, and processes are in place ahead of each new center launch.
• Partner with cross‑functional teams to track go‑live readiness milestones, resolve open items, and confirm operational readiness prior to launch.

Qualifications

• Aligns with our purpose and values and is excited about living those out in daily practice.
• 2-4 years of demonstrated experience, knowledge, and a track record in project management techniques, concepts, principles, and standards.
• Specific healthcare and/or health plan experience required.
• Excellent written and verbal communication skills and the ability to effectively communicate at all levels internally and externally to establish credibility on project teams.
• Can skillfully navigate multiple external systems including those operated by Medicare and Medicaid.
• High proficiency with general Microsoft applications, including Share Point as well as Smartsheet.
• Ability to forecast project challenges and define solutions to maintain compliance with policies and procedures, quality, and schedule.

Nice to have

• Prior experience in PACE

Compensation

The anticipated base salary range for this position is $67,000 - $87,000 annually. This position is also eligible for a target annual bonus and may be eligible for additional incentive compensation, as applicable. The final compensation offered will be determined based on factors including, but not limited to, the candidate's qualifications, skills, experience, education, certifications, geographical location, and business needs.

• medical, dental, and vision insurance
• paid parental leave
• short- and long-term disability coverage
• life insurance
• flexible spending accounts
• a 401(k) savings plan that includes a match
• paid time off
• company paid holidays

Vaccination Policy, including COVID-19

To help maintain a safe environment for our participants and team members, Habitat Health maintains vaccination and infection control policies applicable to certain roles and work locations. For COVID-19 and influenza, team members who are working in a participant care setting are required to provide either proof of vaccination or a signed declination form and comply with applicable masking requirements while in a care setting to the extent permitted by law in the applicable jurisdiction. Habitat Health will consider requests for reasonable accommodation based on an applicant's disability, medical condition, or sincerely held religious belief, practice, or observance in accordance with applicable law. As a condition of employment, team members are expected to comply with all applicable infection control protocols, personal protective equipment (PPE) requirements, and vaccination requirements associated with their role and work location, and to the extent required by law and as permitted in the applicable jurisdiction.

Habitat Health’s Commitment to Equal Opportunity and Inclusion

Habitat Health is an Equal Opportunity Employer committed to the principles of equal opportunity and inclusion. Employment decisions at Habitat Health are based on qualifications, merit, and business needs.

We do not discriminate on the basis of race, color, religion, creed, sex, gender (including pregnancy, childbirth, breastfeeding, and related medical conditions), gender identity, gender expression, sexual orientation, marital status, registered domestic partner status, age, national origin, ancestry, citizenship, military or veteran status, physical or mental disability, medical condition, genetic information, reproductive health decision‑making, or any other characteristic protected by applicable federal, state, or local law.

Habitat Health is committed to the full inclusion of all qualified individuals. Consistent with applicable law, we provide reasonable accommodations to qualified individuals with disabilities and to individuals with religious beliefs, practices, or observances that require accommodation.

If you require a reasonable accommodation to participate in the application or interview process, perform the essential functions of a position, or receive other employment benefits and privileges, please contact us at [e-mail].

We encourage individuals from all backgrounds to apply, even if their experience does not align perfectly with every qualification listed.