WelbeHealth is a value-based healthcare organization that’s transforming the future of senior care by providing an all-inclusive care option to our most vulnerable senior population. We step in as the care provider and care planner that work to keep our participants within their communities, out of institutions, and cared for like family, all while receiving the healthcare and social services needed to thrive.
The AI Business Automation Project Manager, Health Plan Services is accountable for delivering projects and driving operational and technology-enabled improvement within the Eligibility and Reconciliation team, reporting directly into Health Plan Services. This role leads healthcare systems and process improvement projects while also designing and building AI agents and automation workflows that streamline eligibility and reconciliation operations.
This role is different because the AI Business Automation Project Manager, Health Plan Services at WelbeHealth:
- Combines healthcare project management and operational improvement with hands-on AI and automation, providing the opportunity to identify inefficiencies, design practical solutions, and build AI-enabled workflows that directly improve Health Plan Services operations
- Plays a critical role in modernizing eligibility and reconciliation by partnering with business and technical teams to translate complex healthcare processes into scalable technology solutions that reduce manual work, improve accuracy, and strengthen the overall team member and operational experience
We care about our team members. That’s why we offer:
- Medical insurance coverage (Medical, Dental, Vision)
- Work/life balance - We mean it! 17 days of personal time off (PTO), 12 holidays observed annually, and 6 sick days
- 401K savings + match
- Comprehensive compensation package including base pay and bonus
- And additional benefits!
On the day-to-day, you will:
- Drive projects to successful implementation within Health Plan Services, including cross-functional collaboration across Eligibility, Reconciliation, Claims, Network, and other health plan operations teams
- Lead projects that improve or implement systems, tools, and technology used to support eligibility determination, enrollment, and reconciliation processes, partnering with technical teams and vendors to translate business needs into functional solutions
- Design, build, and deploy AI agents and automation workflows that reduce manual work in eligibility, reconciliation, and health plan operations processes, using AI assisted ("vibe coding") development practices to rapidly prototype and deliver working tools
- Partner with Health Plan Services business owners and leadership to gather and translate requirements into high-value opportunities for process automation and agentic AI, and set realistic expectations about capability, accuracy, and risk
- Document project and automation logic clearly so that solutions are maintainable and can be handed off, refined, or governed over time
- Track and report project status, escalating issues when appropriate, as well as organize project resources while tracking and managing any over-allocated resources and motivating the team to complete key deliverables
- Develop a relationship with key stakeholders to ensure delivered projects meet business needs and delight our customers
Job requirements include:
- Bachelor’s degree in relevant field required; master's degree preferred; PMP or Six Sigma Certification preferred
- Minimum of five (5) years of experience in a project management role, ideally including healthcare systems
- Previous experience in a regulated healthcare environment; experience with health plan operations, eligibility, enrollment, or reconciliation systems (Medicaid, Medicare, or commercial) strongly preferred
- Comfortable exploring, designing, and building AI agents or automation workflows using AI platforms and tools, with a focus on practical business use cases rather than deep technical development
- Experience working directly with business owners to gather, document, and translate operational requirements into AI agent and automation solutions
- Ability and willingness to use AI-assisted development tools (e.g., Claude, ChatGPT, or similar) to prototype, test, and improve AI agents or workflow solutions; prior coding experience is helpful but not required
- Comfortable partnering with technical teams using low-code/no-code tools to connect Ai enabled workflows with existing processes and systems, where appropriate
We’re seeking an AI Business Automation Project Manager, Health Plan Services who is energized by solving complex operational challenges, experimenting with AI and automation, and turning business needs into practical technology solutions. If you’re ready to join a team that values both its participants and team members, we’d love to hear from you!
Compensation consists of base salary plus bonus. WelbeHealth offers a competitive total rewards package that includes a 401(k) match, comprehensive healthcare coverage, and a broad range of additional benefits. Actual compensation will be determined based on experience and relevant qualifications.
COVID-19 Vaccination Policy
At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all our employees and proof of vaccination, or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations.
Our Commitment to Diversity, Equity and Inclusion
At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.
Beware of Scams
Please ensure your application is being submitted through a WelbeHealth sponsored site only. Our emails will come from @welbehealth.com email addresses. You will never be asked to purchase your own employment equipment. You can report suspected scam activity to [email protected]
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