Senior Director, Benefits & Eligibility Operations

TBG | The Bachrach Group; New York (NY); On-site; USD 180,000 - 240,000; Full time

Job summary

The Bachrach Group is seeking an experienced Director of Benefits & Eligibility Administration to lead the day-to-day operations of a large healthcare benefits organization. This senior role requires expertise in healthcare eligibility, enrollment, benefits administration, and team leadership.

The Director will oversee a large operational team, ensure accurate member enrollment, regulatory compliance, data integrity, and continuous improvement across the department, working closely with

Qualifications

• Bachelor's degree in Business Administration, Health Administration, or a related field is required.
• Master's degree preferred.

Responsibilities

• Lead, mentor, and develop a large team of management and operational staff.
• Establish performance expectations and promote accountability, professional development, and employee engagement.
• Develop and implement strategies to improve departmental performance and operational efficiency.
• Partner with senior leadership on goals, priorities, and long-term planning.
• Oversee eligibility and enrollment processes for members, dependents, and spouses.
• Ensure enrollment activities are accurate, timely, and compliant with plan requirements and agreements.
• Develop and improve procedures, workflows, and operating standards.
• Monitor department performance and identify opportunities to improve service and efficiency.
• Provide leadership regarding healthcare benefits regulations and eligibility requirements.
• Ensure processes comply with federal and state regulations.
• Oversee member appeals and collaborate with internal legal resources.
• Support regulatory reporting and compliance activities.
• Oversee enterprise eligibility and enrollment systems and related workflows.
• Partner with technology teams on system enhancements and data projects.
• Ensure accuracy and integrity of eligibility and enrollment data.
• Manage data exchanges with external partners and vendors.
• Support employer and member-facing portals and ensure accurate processing of enrollment data.

Skills

Leadership

Regulatory compliance

Data management

Process improvement

Communication

Education

Bachelor's degree in Business Administration, Health Administration, or a related field

Master's degree

Job description

The Bachrach Group is seeking an experienced Director of Benefits & Eligibility Administration to lead the day-to-day operations of a large healthcare benefits organization. This senior role requires expertise in healthcare eligibility, enrollment, benefits administration, and team leadership.

The Director will oversee a large operational team, ensure accurate member enrollment, regulatory compliance, data integrity, and continuous improvement across the department, working closely with