Note: The job is a remote job and is open to candidates in USA. WelbeHealth is hiring an AI Business Automation Project Manager, Health Plan Services to deliver projects and improve operations and technology within its Eligibility and Reconciliation team. The role leads healthcare systems and process improvement projects while designing and building AI agents and automation workflows for eligibility and reconciliation operations.

Responsibilities

• 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

Skills

• Bachelor's degree in relevant field
• Minimum of five (5) years of experience in a project management role
• 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
• Comfortable partnering with technical teams using low-code/no-code tools to connect Ai enabled workflows with existing processes and systems, where appropriate
• Master's degree
• PMP or Six Sigma Certification
• 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)

Benefits

• Medical insurance coverage (Medical, Dental, Vision)
• 17 days of personal time off (PTO)
• 12 holidays observed annually
• 6 sick days
• 401K savings + match
• Bonus
• Remote work in California

Company Overview

Company H1B Sponsorship