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Eligibility Manager Jobs (NOW HIRING)

Work in conjunction with the enrollment and eligibility manager to conduct quality assurance audits to ensure registration and eligibility processes are completed according to clinic policies ...

Previous experience as a Case Manager, Eligibility Specialist, Eligibility Associate, Office Manager, Call Center Customer Service Specialist, or Client Specialist encouraged to apply The Eligibility ...

Previous experience as a Case Manager, Eligibility Specialist, Eligibility Associate, Office Manager, Call Center Customer Service Specialist, or Client Specialist encouraged to apply The Eligibility ...

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Eligibility Manager information

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$14

$22

$33

How much do eligibility manager jobs pay per hour?

As of Jul 4, 2026, the average hourly pay for eligibility manager in the United States is $22.65, according to ZipRecruiter salary data. Most workers in this role earn between $19.23 and $25.96 per hour, depending on experience, location, and employer.

What is the difference between Eligibility Manager vs Claims Specialist?

CriteriaEligibility ManagerClaims Specialist
Required credentialsTypically requires a high school diploma or associate degree; certifications like Certified Eligibility Specialist are commonUsually requires a high school diploma; certifications like Certified Claims Professional are beneficial
Work environmentOffice setting, healthcare or insurance companiesOffice setting, healthcare or insurance companies
Employer and industry usageUsed in healthcare, insurance, government agenciesUsed in healthcare, insurance, and related sectors
Common search and comparison intentUnderstanding roles, responsibilities, and qualificationsUnderstanding differences in claims processing and eligibility

Eligibility Managers focus on verifying patient or client eligibility for services or benefits, ensuring compliance with policies. Claims Specialists handle processing and adjudicating insurance claims, focusing on reimbursement and accuracy. While both roles operate within healthcare and insurance sectors, Eligibility Managers primarily verify eligibility, whereas Claims Specialists manage claims processing.

What are the key skills and qualifications needed to thrive as an Eligibility Manager, and why are they important?

To thrive as an Eligibility Manager, you need expertise in eligibility determination, compliance regulations, and case management, often supported by a bachelor's degree in social work, public administration, or a related field. Familiarity with eligibility management systems, case tracking software, and knowledge of relevant federal and state regulations is typically required. Strong leadership, problem-solving, and communication skills help in managing teams and resolving complex eligibility cases. These competencies are vital for ensuring accurate eligibility determinations, regulatory compliance, and efficient program operations.

What is the best job for people with disabilities?

Eligibility Managers typically work in administrative or compliance roles that may be suitable for people with disabilities, depending on their specific abilities and accommodations. Many jobs for people with disabilities focus on remote work, flexible schedules, and roles that require skills such as organization, communication, or technical proficiency. Employers are increasingly providing accommodations to support diverse needs in various industries.

Is being a MOA a good entry level job?

A Medical Office Assistant (MOA) position is often considered an entry-level healthcare role that provides basic administrative and clinical support skills. It can serve as a stepping stone into the healthcare field, requiring minimal prior experience and often involving tasks like scheduling, data entry, and patient communication.

What jobs pay 4000 a week without a degree?

Eligibility Managers typically do not earn $4,000 a week without a degree, as the role often requires specialized knowledge and experience. However, high-paying jobs without a degree can include sales managers, real estate brokers, or skilled trades such as electricians or plumbers, especially with experience and certifications. These roles may involve commission, bonuses, or overtime to reach that income level.

What is the highest paying managerial job?

The highest paying managerial roles are often executive positions such as Chief Executive Officer (CEO), Chief Financial Officer (CFO), or Chief Operating Officer (COO), which can earn multi-million dollar salaries including bonuses and stock options. These roles typically require extensive experience, advanced degrees, and strong leadership skills, and they oversee large organizations or divisions.

What are the most common challenges faced by an Eligibility Manager in ensuring compliance with changing regulations?

Eligibility Managers often encounter challenges related to staying up-to-date with frequently changing federal, state, and local regulations that impact program eligibility criteria. They must ensure that their team is properly trained on new policies and that all documentation and procedures remain compliant. Additionally, balancing high caseloads while maintaining accuracy and timeliness in processing applications can be demanding. Effective communication with both applicants and internal departments is crucial to navigate complex cases and resolve discrepancies efficiently.

What is an Eligibility Manager?

An Eligibility Manager is a professional responsible for overseeing and managing the process of determining if individuals or groups qualify for specific programs, benefits, or services. They typically work for government agencies, healthcare organizations, or insurance companies. Their duties include supervising eligibility staff, ensuring compliance with policies and regulations, and resolving complex eligibility determinations or appeals. Eligibility Managers play a crucial role in making sure that assistance is provided to those who meet the necessary requirements, while preventing fraud and misuse of resources.
More about Eligibility Manager jobs
What cities are hiring for Eligibility Manager jobs? Cities with the most Eligibility Manager job openings:
What are the most commonly searched types of Eligibility jobs? The most popular types of Eligibility jobs are:
What states have the most Eligibility Manager jobs? States with the most job openings for Eligibility Manager jobs include:
Infographic showing various Eligibility Manager job openings in the United States as of June 2026, with employment types broken down into 1% As Needed, 85% Full Time, 12% Part Time, and 2% Contract. Highlights an 97% Physical, 1% Hybrid, and 2% Remote job distribution, with an average salary of $47,119 per year, or $22.7 per hour.
Enrollment & Eligibility Manager

Enrollment & Eligibility Manager

UnitedHealth Group

Dallas, TX • Remote

Full-time

Retirement

Posted 6 days ago


UnitedHealth Group rating

7.6

Company rating: 7.6 out of 10

Based on 145 frontline employees who took The Breakroom Quiz

189th of 877 rated healthcare providers


Job description

This position is National Remote. You'll enjoy the flexibility to telecommute* from anywhere within the U.S. as you take on some tough challenges. For all hires in Minneapolis, Virginia, Maryland, or Washington, D.C. area, you will be required to work in the office for a minimum of four (4) days per week.

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.

The Enrollment & Eligibility Manager will be responsible to oversee day to day activities related to enrollment and eligibility operations in order to accomplish the business and their team's objectives. Our Manager's and their teams have a serious responsibility to make every contact informative, productive, positive, and memorable.

This position is full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm local time zone. It may be necessary, given the business need, to work occasional overtime. 

We offer weeks of on-the-job training. The hours of training will be aligned with your schedule. 

Primary Responsibilities:

  • Supervise Eligibility Supervisor's and Representatives in their daily job functions to ensure files are applied timely and all turnaround times and quality standards are met and/or exceeded
  • Meet and exceed department quality audits and provide coaching to their supervisor's and team members
  • Maintain and prioritize eligibility discrepancies, analyzing transactional data & submitting retroactive eligibility changes to the director and senior leaders
  • Monitoring eligibility reconciliation based on received capitation and monthly variance reports 
  • Handle all escalations courteously, politely and professionally
  • Act as back-up support for other Managers as needed for meetings and other departmental responsibilities
  • Advise management in long-range planning for areas of specialization
  • Perform other duties as assigned
  • Managing team productivity, time cards, and attendance reporting
  • Handle risk identification and perform root-cause analysis
  • Conduct monthly reporting for team and departmental status updates/briefings
  • Monitoring inventory & capacity reports and workload volumes for identification of needs for capacity planning and/or cross-coverage within the department
  • Inter-departmental collaboration with other core operations teams

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • High School Diploma / GED or equivalent work experience
  • Must be 18 years of age or older
  • 3 years of billing and/or eligibility experience
  • 3 years of Management or Supervisory experience to include experience with managing direct reports
  • Proficiency with computer and Windows PC applications
  • Intermediate level experience using Microsoft Excel & PowerPoint
  • Ability to work full-time (40 hours/week) Monday - Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during our normal business hours of 8am - 5pm local time zone. It may be necessary, given the business need, to work occasional overtime

Preferred Qualifications:

  • Experience with EPIC OR EZCap
  • Experience with Eligibility Manager
  • Experience with FACETS
  • Interpersonal skills
  • Ability for oral and written communication skills
  • Must have the ability to handle multiple issues and prioritize appropriately while working swiftly & efficiently without compromising quality customer service
  • Organizational skills with the ability to prioritize caseload based on business and customer need as well as respond appropriately and effectively in difficult situations
  • Knowledge of Human Resources policies and procedures

Telecommuting Requirements:

  • Ability to keep all company sensitive documents secure (if applicable)
  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy
  • Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service

*All employees working remotely will be required to adhere to UnitedHealth Group's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from  $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. 

   

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission.

   

   

UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

   

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.


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