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Eligibility Consultant
Job Description:
- Serve as a pivotal resource for the organization’s intricate and high-value client portfolios
- Autonomous management and resolution of multifaceted eligibility issues
- Engage cross-functionally with internal departments, external clients, and broker partners to deliver expert guidance and solutions
- Function as the principal escalation point prior to Manager or Director intervention
- Ongoing development and mentorship of junior staff
- Design and implement comprehensive training programs
- Orchestrate and align daily operational objectives
- Identify and execute process optimization strategies
- Leverage subject matter expertise to drive continuous improvement and operational excellence across the eligibility function
Requirements:
- 3-4 years experience as an Eligibility Consultant, with a proven track record of managing complex eligibility and policy data for high-value plan sponsors
- Advanced proficiency in the accurate and timely processing of eligibility data, ensuring alignment with client requirements and organizational standards
- Ability to synthesize organizational intent and end-state objectives, operating with a high degree of autonomy to achieve desired outcomes
- Exceptional organizational skills, with the capacity to manage multiple concurrent priorities in a dynamic environment
- Demonstrated ability to function both independently and as an integral member of a collaborative team
- Consistent delivery of precise and timely results, with effective delegation and follow-up as required
- Experience in coaching and mentoring junior colleagues, including the design, development, and facilitation of transitional training programs to support the seamless integration of new hires from classroom instruction to full productivity
- Proven ability to identify, recommend, and implement process improvements and operational efficiencies
Benefits:
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching
- Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility
