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Director, Eligibility Operations

AT Collective Health
Collective Health

Director, Eligibility Operations

Plano, TX

At Collective Health, we’re transforming how employers and their people engage with their health benefits by seamlessly integrating cutting-edge technology, compassionate service, and world-class user experience design.

Collective Health is expanding its Customer Experience team in Utah! We believe health benefits should be simple, accessible, and technology-driven. But moreover, we believe healthcare should be grounded by the people that it serves. To accomplish this, we are reimagining the operational core of health insurance. We are seeking leaders to help deliver on this vision. 

We are hiring an experienced leader to lead and scale our Eligibility operations teams and processes. In this role, you will be the strategic leader for inbound and outbound eligibility teams, composed of analysts and associates supporting clients, partners and internal stakeholders. You will work closely with your team to set strategy and goals for your department, ensure appropriate metrics and performance management are effectively functioning and evolving and create a culture of high performance, accountability and growth. You will also partner closely with teams through-out the business to collaborate on problem solving and ensuring highly effective processes and policies are in place to maximize the effectiveness of cross functionally work. This includes partnering with Client Success teams, Product and Engineering to continually work to evolve and improve our capabilities to consistently build their confidence in the team’s performance.

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The ideal candidate will have health insurance experience and a deep understanding of electronic data exchange, previous success with collaborating with product and development organizations and a strong track record of scaling operations teams. This leader will have experience building an inclusive and engaged organization with a focus on developing leaders to reach their full potential. 

Key Responsibilities:

  • Leadership:
    • Create an inclusive and engaged team across the Eligibility Ops teams
    • Continually develop the leadership team across both functions
    • Take ownership and work cross-functionally with multiple CX teams, Legal, Product, Engineering, and Client Success to identify and resolve issues
  • Operations:
    • Own and drive operational excellence and rigor within the organization.
    • Directly responsible for the performance of the Eligibility operations team, including meeting/exceeding KPIs.
    • Create a strong partnership with the Client Success teams and support timely resolution of client issues
    • Monitor and ensure timely resolution of member inquiries
    • This includes ensuring the accurate and timely intake, QA, storage and dissemination of data that is key to the successful operation of Collective Health and to our clients, partners and members experience of our product.
    • Manage the successful integration of new file feeds for new and renewal clients
  • Scaling:
    • Drive scalability across all functions and processes within the organization.
    • End-to-end analysis of systems and processes, identifying areas for improved efficiency, accuracy and scalability
    • Collaborate cross functionally to drive technology enabled solutions to enable the teams to scale. This includes partnering with teams across Product, Engineering, Product Operations and other teams as needed. 
  • Continuous improvement:
    • End-to-end analysis of systems and processes, identifying areas for improved efficiency, automation, accuracy and scalability
    • Create performance metrics across the various functions and drive operational excellence across the team
  • Creative, passionate, and driven about building key business functions that transform customer and employee experiences
  • Dynamic communication skills - Able to lead and work closely with all levels of management and effectively manage challenging conversations with the most demanding of clients
  • Strong process and metric orientation
  • Natural proclivity toward Collective Health’s values of Connect with empathy, Engage Authentically, Dare to Solve Hard Problems, Follow Our Curiosity
  • Analytical Skills –  Mathematical / analytical aptitude, ability to translate operational concepts into measurable results, and vice versa.
  • Leadership Skills – Ability to define and set vision and obtain buy in and make quick progress against challenging goals
  • Change Management – The ability to help counterparts through difficult transitions to a new process, workflow, or situation.
  • Interpersonal Skills – The ability to establish oneself as a peer and trusted partner.
  • Motivation / Drive – Successful candidates will be the quintessential self-starter and have a desire for continuous learning.  Going beyond what is asked to take on new challenges and create innovative solutions is critical to success, and have the ability to inspire others to do the same.

Skills and Qualifications:

  • Bachelor's degree in Computer Systems, Business Administration, or a related field(s). In lieu of a bachelor's degree, a combination of education, certifications, and relevant professional experience will be considered.
  • 10+ years of experience in healthcare technology-related operations.
  • 5+ years of direct management experience, including managing remote teams.
  • Experience with HIPAA and ANSI 834 EDI is required.
  • Experience implementing complex technical/process projects
  • Ability to speak and connect with both technical and business personnel, at all levels
  • Ability to make progress, recommendations and decisions with incomplete information
  • Ability to understand, analyze and envision the end-to-end process
  • Experience working with external vendors and clients
  • Member and client focused (customer centricity)
  • You enjoy a fast paced team environment and adapt well to change by adjusting priorities as needed
  • You have excellent verbal, written and interpersonal communication skills
  • You are analytically minded and like to make data-driven decisions
  • You are a self-motivator and self-starter
  • Excellent verbal and written communication skills

Pay Transparency Statement 

This is a hybrid position based out of one of our offices: San Francisco, CA, Plano, TX, or Lehi, UT. Hybrid employees are expected to be in the office three days per week (Plano, TX) or two days per week (San Francisco, CA or Lehi, UT). #LI-hybrid

The actual pay rate offered within the range will depend on factors including geographic location, qualifications, experience, and internal equity. In addition to the salary, you will be eligible for stock options and benefits like health insurance, 401k, and paid time off. Learn more about our benefits at https://jobs.collectivehealth.com/benefits/.

Lehi, UT Pay Range
$130,500$163,000 USD

Why Join Us?

  • Mission-driven culture that values innovation, collaboration, and a commitment to excellence in healthcare
  • Impactful projects that shape the future of our organization
  • Opportunities for professional development through internal mobility opportunities, mentorship programs, and courses tailored to your interests
  • Flexible work arrangements and a supportive work-life balance

We are an equal opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status. Collective Health is committed to providing support to candidates who require reasonable accommodation during the interview process. If you need assistance, please contact recruiting-accommodations@collectivehealth.com.

Privacy Notice

For more information about why we need your data and how we use it, please see our privacy policy: https://collectivehealth.com/privacy-policy/.

Client-provided location(s): Plano, TX, USA; Lehi, UT, USA
Job ID: 6318721
Employment Type: Other