Lead, Medicare & Medicaid Eligibility Operations

WelbeHealth; Los Angeles (CA); On-site; USD 90,000 - 119,000; Full time

Benefits offered by this job

Medical insurance (Medical, Dental, V

PTO & holidays

401K match

Bonus included

Comprehensive compensation package

Job summary

WelbeHealth seeks a Supervisor, Eligibility & Coverage to lead the Eligibility Advocate team handling Medicaid and Medicare enrollment for CA participants. You will drive priorities, guide coordinators, and strengthen workflows to ensure continuous coverage and timely renewals across the PACE model.

Ideal candidates bring 3+ years in Medicaid/Medicare eligibility, 2+ years of supervision, and a data-driven mindset to optimize performance and outcomes for seniors and their families.

Qualifications

• Associate's degree in relevant field; additional professional experience may substitute.
• Minimum of three (3) years of Medicaid/Medicare eligibility or social services experience.
• Minimum of one (1) year of experience with governmental agencies.
• Two (2) years of supervisory experience with mentoring and development demonstrated.
• Strong KPI management and data-driven prioritization of people and projects.
• Experience leading eligibility teams for PACE organizations preferred.

Responsibilities

• Manage the Eligibility Advocate team, ensuring eligibility maintenance, reinstatements, and enrollment processing across Medicaid and Medicare.
• Set priorities, caseloads, and workflow assignments for Eligibility Advocates and Coordinators.
• Develop outreach strategies to proactively prevent coverage lapses.
• Oversee enrollment and disenrollment processing with DHCS and CMS.
• Manage direct reports including hiring, training, supervising, and mentoring.
• Partner with Operations, Quality, and Enrollment leaders to refine workflows and SOPs.
• Support implementation of new eligibility policies or regulatory changes and training.
• Maintain and improve tracking tools such as hold trackers and renewal logs.

Skills

KPI Management

Leadership

Data-driven decision making

Team mentorship

Medicaid/Medicare knowledge

Education

Associate's degree in relevant field

Job description

WelbeHealth seeks a Supervisor, Eligibility & Coverage to lead the Eligibility Advocate team handling Medicaid and Medicare enrollment for CA participants. You will drive priorities, guide coordinators, and strengthen workflows to ensure continuous coverage and timely renewals across the PACE model.

Ideal candidates bring 3+ years in Medicaid/Medicare eligibility, 2+ years of supervision, and a data-driven mindset to optimize performance and outcomes for seniors and their families.