Senior Manager, Patient Eligibility

Role Overview

• Serve as the primary operational leader for one or more major clients within multiple regions, managing $3.6M+ in revenue and/or multiple service lines.
• Own day-to-day client relationships, ensuring service level agreements (SLAs), quality standards, and performance expectations are met.
• Lead client meetings as appropriate; prepare, review, and present weekly and monthly operational reports.
• Proactively identify service risks, performance gaps, or potential contractual concerns and escalates appropriately.
• Partner in new client implementations, including operational planning, staffing models, training coordination, and go-live support.
• Drive continuous improvement initiatives to enhance client satisfaction and operational outcomes.
• Act as an escalation point for complex cases, working with internal and external stakeholders to resolve issues promptly.
• Oversee workflow management, productivity, and quality assurance processes to ensure timely and accurate processing of eligibility accounts.
• Ensure adherence to QA standards; review audit results, implement remedial training and/or corrective actions, and monitor sustained improvement.
• Develop, refine, and enforce policies and procedures to align with regulatory, compliance, and client requirements.
• Identify opportunities to improve processes, leverage technology, and enhance eligibility workflows.
• Monitor compliance with HIPAA, Medicaid, Charity Care, Disability, and other regulatory guidelines.
• Accountable for operational financial performance, including revenue, expense management, and margin optimization.
• Review monthly P&L statements and partner with the General Manager or Vice President to address variances and implement improvement strategies.
• Support annual budgeting and forecasting processes.
• Lead, mentor, and develop a multi-layered eligibility team, including several supervisors and managers and their direct reports, ensuring alignment with organizational goals, operational standards, and performance expectations.
• Establish team performance expectations aligned with organizational and client goals.
• Monitor team and individual performance and quality metrics, providing regular feedback and implement corrective action and performance improvement plans as necessary.
• Oversee hiring, onboarding, performance management, coaching, corrective actions, and terminations in partnership with HR.
• Manage workforce planning, scheduling, overtime oversight, travel expenditures, and resource allocation to ensure productivity and coverage standards are achieved.
• Ensure colleagues receive appropriate training, tools, and development opportunities to perform effectively.

Requirements

• Bachelor’s degree in business management, healthcare administration or equivalent combination of education and experience.
• Minimum 5+ years of progressive experience in healthcare eligibility, revenue cycle, Medicaid, Disability, and/or Charity Care services.
• Minimum 5+ years of people leadership experience managing large teams (30+ colleagues).
• Proven ability to build and maintain strong client relationships, balancing service excellence with adherence to contractual agreements and operational standards.
• Strong knowledge of regulatory requirements within healthcare financial assistance programs.
• Financial acumen with experience reviewing budgets, revenue, and expense performance.
• Strong ability to handle multiple competing priorities.
• Advanced proficiency in Microsoft Excel and reporting tools.
• Strong analytical, organizational, and communication skills.
• Proven ability to lead teams, manage change, and drive results in a client-facing environment.

Benefits

• Health insurance
• Flexible work hours
• Professional development opportunities