Jobs at WelbeHealth

The Dispute Specialist investigates and resolves first-level provider disputes involving claim payments, denials, and contractual agreements. The role prepares acknowledgment and determination letters, documents dispute decisions, identifies claim-processing trends, supports compliance, educates providers, and collaborates with internal teams and leadership. It also assists with clean-claim data entry as needed while maintaining knowledge of claims procedures, regulations, and medical billing guidelines.

Manages the full provider relationship lifecycle, including identifying prospective partners, advocating for the PACE model, leading contract negotiations, onboarding providers, and overseeing ongoing network performance. Builds trusted relationships with providers and health systems while coordinating with clinical operations, utilization management, claims, and PACE leadership to improve access, workflow integration, and provider satisfaction.

Leads hands-on architecture, development, and delivery of secure healthcare systems while mentoring engineers and establishing engineering standards. Drives Azure, microservices, DevSecOps, automated testing, AI-assisted development, and scalable solutions. Partners with product, clinical, cloud, and security stakeholders to translate business needs into technical direction and support WelbeHealth’s PACE model.

Develop, test, deploy, maintain, and optimize software solutions using Microsoft technologies and Azure cloud services. Collaborate with business stakeholders, architects, security, infrastructure, product, and support teams throughout the software development lifecycle. Modernize legacy applications, build REST APIs, implement automated testing, ensure PCI and HIPAA compliance, document systems, manage releases, and support production troubleshooting, monitoring, performance, and reliability.

Leads enterprise cloud and application architecture, designing scalable cross-functional systems, platforms, integrations, and technology roadmaps. Provides hands-on solution design, code review, technical mentorship, and leadership across development and IT teams. Ensures alignment with enterprise standards, security, business strategy, healthcare interoperability, and HL7 requirements. Evaluates project risks, testing, monitoring, and implementation while collaborating with system owners and external partners. Requires extensive architecture experience plus healthcare, payer data, X12, and EMR expertise.

Supervise and support scheduling team to ensure timely, accurate appointment scheduling for participants; troubleshoot escalations; audit scheduling data for quality and compliance; manage productivity and coach staff; collaborate with care teams and providers to maintain exceptional customer service.

Oversee and ensure accurate, timely scheduling of participant appointments; troubleshoot and resolve escalations; audit scheduling data for quality and compliance; perform administrative and compliance tasks; directly supervise and coach scheduling staff; monitor productivity and adherence to policies; ensure professional, timely communication with participants, families, providers, and internal teams.

Prepares external, regulatory, lender, and management financial reports; coordinates monthly, quarterly, and annual reporting; supports close, audits, and healthcare finance projects; analyzes reporting metrics; and builds scalable reporting processes, controls, automation, and documentation. The role requires strong technical accounting expertise, cross-functional coordination, regulatory reporting knowledge, and preferably healthcare experience involving Medicare, Medicaid, or PACE.

Leads healthcare systems and process-improvement projects within Health Plan Services. Designs and deploys AI agents and automation workflows for eligibility and reconciliation operations, translates business requirements into technology solutions, coordinates cross-functional teams and vendors, tracks project delivery, documents automation logic, and manages risks, resources, and stakeholder expectations.

Lead an individual clinic as its CEO: own P&L, oversee care quality and regulatory compliance, develop and mentor leadership, manage budgets with finance, drive enrollment with marketing, build external stakeholder relationships, and contribute to strategic planning and best-practice sharing across programs.

Build community relationships and generate qualified referrals to drive enrollment in WelbeHealth’s PACE program. Coordinate outreach activities, collaborate with senior centers and community organizations, develop monthly marketing plans, achieve enrollment goals, and educate referral sources about services. The role emphasizes relationship-based community engagement rather than hard selling.

Leads enterprise provider network strategy and managed care contracting across existing and emerging markets. Responsibilities include assessing network adequacy, supporting market expansion, negotiating with hospitals and provider groups, developing value-based contracting approaches, monitoring regulatory and competitive trends, and managing a high-performing network strategy and contracting team. The role collaborates with Finance, Analytics, Operations, Compliance, clinical leadership, and growth teams to improve access, quality, and financial sustainability.

Supervise and support scheduling team to ensure timely, accurate appointment scheduling for PACE participants. Handle escalations, audit scheduling data for quality and compliance, coach staff, monitor productivity, and coordinate with interdisciplinary teams, providers, participants, and families to deliver empathetic, high-quality customer service within established protocols.

Leads enterprise agile delivery across technology and data teams, coaches Scrum Masters and development teams, establishes Agile practices, facilitates Scrum ceremonies, removes systemic impediments, improves team performance, and aligns solution delivery with strategic business objectives. The role also manages large-scale initiatives, partners with Product and technical teams, and mentors Scrum team members.

Lead regional quality and regulatory compliance efforts across PACE markets. Manage root cause analyses, develop and track corrective action plans, analyze CAP outcomes, partner with cross-functional leadership, and drive continuous improvement to ensure participant safety and compliance with federal, state, and contractual requirements.

Build community relationships and generate qualified referrals to drive enrollment in WelbeHealth’s PACE program. Coordinate outreach activities, collaborate with senior centers and community organizations, develop monthly marketing plans, achieve enrollment goals, and educate referral sources about services. The role emphasizes relationship-based community outreach rather than hard selling and requires sales or marketing experience, preferably in healthcare or senior care.

Build community relationships and generate qualified referrals for WelbeHealth’s PACE program. Coordinate outreach activities, collaborate with senior centers and community organizations, develop monthly marketing plans, achieve enrollment goals, and educate referral sources about services. The role emphasizes relationship-based community engagement rather than hard selling and requires sales or marketing experience, preferably in healthcare or senior care.

Supervise and coach the scheduling team to ensure timely, accurate appointment scheduling in the EMR. Troubleshoot escalations, audit scheduling data for quality and compliance, manage productivity and performance, support administrative and regulatory tasks, and maintain professional communication with participants, families, providers, and internal teams.

The Provider Network Strategy Principal at WelbeHealth will analyze network performance, create reports, lead initiatives for improvement, and collaborate with teams to optimize provider outcomes.

The Outside Sales Specialist connects seniors with healthcare services, building community relationships, and managing outreach to enhance enrollment success in the PACE program.