Health Plan Operations Associate

Modern Health; Tampa (FL); Remote; USD 46,000 - 55,000; Full time

Job summary

Modern Health is on the lookout for a Health Plan Operations Associate to enhance their team. The successful candidate will manage claims processing and support systems integration, ensuring an efficient workflow that benefits their mission in mental health. This fully remote position values individuals who bring attention to detail and strong communication skills to the operations team.

Benefits

Medical / Dental / Vision Insurance

Flexible Spending Account (FSA)

Generous Time Off

Professional Development Stipend

401k

Annual Wellness Stipend

New Hire Stipend

Monthly Cell Phone Reimbursement

Qualifications

• 1-2 years of relevant work experience, preferably in claims.
• Excellent communication skills (verbal and written).
• Highly detail-oriented and organized.

Responsibilities

• Track claims and denials through the entire claim lifecycle.
• Manage and establish new systems to support claims processing.
• Help members troubleshoot issues involving claims or eligibility.

Skills

Attention to detail

Communication

Problem-solving

Education

Relevant work experience

Job description

Modern Health

Modern Health is a mental health benefits platform for employers. We are the first global mental health solution to offer employees access to one-on-one, group, and self-serve digital resources for their emotional, professional, social, financial, and physical well-being needs—all within a single platform. Whether someone wants to proactively manage stress or treat depression, Modern Health guides people to the right care at the right time. We empower companies to help all their employees be the best version of themselves, and believe in meeting people wherever they are in their mental health journey.

Modern Health is backed by investors like Kleiner Perkins, Founders Fund, John Doerr, Y Combinator, and Battery Ventures and raised more than $170 million in less than two years, making Modern Health the fastest entirely female-founded company in the U.S. to reach Unicorn status.

More about our culture and what you can expect when you join the team:

• "It Takes a Village" culture. Modern Health has a unique and unabashed culture centered around high empathy and high accountability - with a drive to win. We are energized by bringing together the best talent in the industry to achieve audacious goals focused on making mental health a strength and priority for all.
• We have an obsession to win. We are highly ambitious and passionate about the work that we do. We take pride in delivering excellence and our personal best and we continuously innovate to uniquely solve our customers' needs.
• We are accountable and can rely on each other. We are a team and hold ourselves and each other accountable. We believe in transparent communication and continuous feedback to foster a culture of trust, reliability, and growth.
• We demonstrate empathy. We have a supportive and diverse culture where we bolster and uplift each other as we pursue our lofty goals. We encourage selflessness and a willingness to support others, fostering a collaborative and respectful environment.
• We exhibit a bias towards action. This is a fast-paced environment. We jump into problems and initiate solutions. We empower our people to make decisions and experiment, iterate, and repeat until we get it right.
  
  

Modern Health is a fully remote workforce and a hyper-growth company that is often recognized for its excellence, winning awards such as World's Most Innovative Companies of 2023 by Fast Company, Top 25 Companies of San Francisco 2023, and 2023 Well-Being Trailblazer Award. To protect our culture and help our team stay connected, we require overlapping hours for everyone. While many roles may function from anywhere in the world—see individual job listing for more—team members who live outside the Pacific time zone are expected to work at least six hours between 8 am and 5 pm Pacific time each workday.

We are looking for driven, creative, and passionate individuals to join in our mission. An inclusive and diverse culture are key components of mental well-being in the workplace, and that starts with how we build our own team. If you're excited about a role, we'd love to hear from you!

The Role

Modern Health is looking to add a Health Plan Operations Associate to our team. In this role, you will help us maintain foundational systems and processes to support all aspects of health plan integration: member health plan eligibility checks, medical claim submissions, claim tracking, member payments, and other areas. This role reports to the Health Plan Operations Senior Manager.

This position is open to candidates residing in AL, AZ, AR, CT, DE, FL, GA, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MO, MT, NE, NV, NH, NJ, NM, NC, ND, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VT, VA, WV, WI, WY.

What You'll Do

• Track claims and denials through the entire claim lifecycle
• Manage and establish new systems to support claims processing and related areas
• Identify gaps in claims and reach out to providers for missing information
• Help members troubleshoot issues involving claims or eligibility
• Create documentation and training materials for the broader Ops team
• Provide reporting and other visibility into this function
• Complete other special projects as needed
  
  

Who You Are

• You have 1-2 years of relevant work experience (claims experience is a plus)
• You are highly detail-oriented and organized
• You are a structured thinker and love checking things off your to-do list
• You have excellent verbal and written communication skills
• You are a problem solver and are able to analyze, troubleshoot and resolve issues
• You enjoy working with different kinds of people and are great at building relationships
• You are a team player who enjoys identifying group pain points and improving them
• You are humble, scrappy, and thrive in fast-paced environments
  
  

Benefits

Fundamentals:

• Medical / Dental / Vision / Disability / Life Insurance
• High Deductible Health Plan with Health Savings Account (HSA) option
• Flexible Spending Account (FSA)
• Access to coaches and therapists through Modern Health's platform
• Generous Time Off
• Company-wide Collective Pause Days
  
  

Family Support:

• Parental Leave Policy
• Family Forming Benefit through Carrot
• Family Assistance Benefit through UrbanSitter
  
  

Professional Development:

• Professional Development Stipend
  
  

Financial Wellness:

• 401k
• Financial Planning Benefit through Origin
  
  

But wait there's more…!

• Annual Wellness Stipend to use on items that promote your overall well being
• New Hire Stipend to help cover work-from-home setup costs
• ModSquad Community: Virtual events like active ERGs, holiday themed activities, team-building events and more
• Monthly Cell Phone Reimbursement
  
  

Equal Pay for Equal Work Act Information

Please refer to the ranges below to find the starting annual pay range for individuals applying to work remotely from the following locations for this role.

• Zone 1: San Francisco Bay Area and New York City Metro
• Zone 2: All other California locations and Seattle, WA
• Zone 3: All other New York locations, All other Washington locations, Washington DC, Austin, TX, CT, IL, MA, NH, NJ, OR, RI, VT
• Zone 4: All other Texas locations, AL, AK, AZ, AR, CO, DE, FL, GA, HI, ID, IN, IA, KS, KY, LA, ME, MD, MI, MN, MS, MO, MT, NE, NV, NM, NC, ND, OH, OK, PA, SC, SD, TN, UT, VA, WV, WI, WY
  
  

Compensation for the role will depend on a number of factors, including a candidate's qualifications, skills, competencies, and experience and may fall outside of the range shown. Ranges are not necessarily indicative of the associated starting pay range in other locations. Full-time employees are also eligible for Modern Health's equity program and incredible benefits package. See our Careers page for more information.

Depending on the scope of the role, some ranges are indicative of On Target Earnings (OTE) and includes both base pay and commission at 100% achievement of established targets.

Zone 1

$62,100—$73,000 USD

Zone 2

$55,900—$65,700 USD

Zone 3

$49,700—$58,400 USD

Zone 4

$46,600—$54,750 USD

We use a third-party AI tool (Endorsed) to assist in the initial screening of applications. As part of the evaluation process, we provide Endorsed with job requirements and candidate-submitted applications. Final hiring decisions are made by our human recruitment team, and no automated system makes the ultimate decision regarding hiring. Certain features of the platform may qualify it as an Automated Employment Decision Tool (AEDT) under applicable regulations. We began using Endorsed on May 12, 2025. You can review the independent bias audit report covering our use of Endorsed here. By submitting your application, you acknowledge that your application may be processed by AI systems as part of the screening and selection process. If you have any questions or would like to request a separate review of your application, please contact [e-mail] with "Separate Review Request" in the email subject line.

Below, we are asking you to complete identity information for the Equal Employment Opportunity Commission (EEOC). While we are required by law to ask these questions in the format provided by the EEOC, at Modern Health we know that gender is not binary, and we recognize that these categories do not reflect our employees' full range of identities.