Director of Client Eligibility

3 weeks ago

Mesa, United States LHH Recruitment Solutions Full time
Job DescriptionJob Description

As the Director of Client Eligibility, you’ll spearhead the planning, development, and implementation of all eligibility and enrollment processes across the organization. Your leadership will directly influence access to essential health services, ensuring smooth administration and compliance with industry regulations.

You’ll oversee internal controls, audits, and ensure that all processes adhere to the Code of Federal Regulations, Arizona Administrative Code, and the Arizona Department of Health Services guidelines. Your strategic vision will help guide our eligibility and enrollment efforts across the entire organization, from behavioral health services to physical healthcare.

Responsibilities:

  • Lead the eligibility and enrollment functions for all organizational locations and services.

  • Ensure compliance with federal, state, and local regulations, including the Arizona Health Care Cost Containment System Provider Manual.

  • Implement and oversee internal controls and audits to maintain regulatory compliance.

  • Provide expert guidance on Medicaid, commercial insurance, and other public healthcare systems.

  • Monitor clinical cost center budgets and ensure alignment with organizational policies.

  • Collaborate cross-functionally to streamline data reporting and analysis for improved operational efficiency.

  • Serve as the central oversight authority for all eligibility-related matters, influencing organizational success.



What We’re Looking For:

  • 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 healthcare or behavioral health industry.

  • In-depth knowledge of Medicaid, commercial insurance, and public healthcare systems.

  • Expertise in navigating complex regulations, including CPT-4, HCPC, and Revenue Codes.

  • Ability to access and interpret benefits for various healthcare funding streams (e.g., Medicaid, SUBG, MHBG, SOR).


Benefits package

  • 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



 



Pay Details: $80,000.00 to $95,000.00 per year

Search managed by: Joanna Calderon

Equal Opportunity Employer/Veterans/Disabled

To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.lhh.com/us/en/candidate-privacy

The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
  • The California Fair Chance Act
  • Los Angeles City Fair Chance Ordinance
  • Los Angeles County Fair Chance Ordinance for Employers
  • San Francisco Fair Chance Ordinance

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