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Director of Client Eligibility and Access

2 months ago


Mesa, Arizona, United States LHH Recruitment Solutions Full time
Job Title: Director of Client Eligibility

LHH Recruitment Solutions is seeking a highly skilled and experienced Director of Client Eligibility to spearhead the planning, development, and implementation of all eligibility and enrollment processes across the organization.

Key Responsibilities:
  • Develop and implement strategic initiatives to address state-by-state variations in benefits and payer requirements.
  • Manage eligibility, benefits, and coverage determination strategies across multiple states, ensuring compliance with state, federal, and payer-specific regulations.
  • Supervise a team of enrollment specialists, guiding them in managing enrollment, eligibility, and benefit processes, including resolving issues with payers and tracking enrollment trends.
  • Use data analytics tools to identify trends in population data, discrepancies in coverage, and opportunities for improved payer relations and business growth.
  • Collaborate with departments such as Utilization Review, Billing, Contracting, and IT to streamline communication and improve cross-functional operations.
Requirements:
  • Bachelor's degree in behavioral health, healthcare administration, or a related field (Master's degree preferred).
  • A minimum of 3 years of behavioral health experience, particularly in eligibility verification, benefit management, and enrollment.
  • A minimum of 5 years of progressive management experience, ideally within the behavioral health industry.
  • In-depth knowledge of Medicaid, commercial insurance, and public healthcare systems.
  • Expertise in navigating complex regulations, including CPT, HCPC, and Revenue Codes.
What We Offer:
  • Generous PTO accrual (5 weeks).
  • Medical, Dental, Vision, Disability, Life, Supplemental plans.
  • Hospital indemnity/Critical Illness.
  • Pet Insurance.
  • Dependent Care Savings, Health Care Savings.
  • 401K with employer match - 100% vested upon enrollment.
  • Wellness programs.
  • Tuition Reimbursement and Scholarship Programs, incentives, and more.

Salary Range: $80,000.00 to $95,000.00 per year

Equal Opportunity Employer/Veterans/Disabled