Manager, Coverage Distribution Operations (ACA/Medicare)

TL;DR

Manager, Coverage Distribution Operations (ACA/Medicare): Building and operating ACA and Medicare coverage distribution workflows for community health center patients with an accent on compliant enrollment, agent readiness, and patient-first operations. Focus on launching live call operations, coaching licensed agents, optimizing Five9 workflows, and scaling staffing based on service-level data.

Location: Remote within the United States; remote-first with a multi-state scope and occasional travel for Medicare clinic events, on-site readiness, and quarterly company-wide onsites.

Salary: $90,000–$100,000 plus performance incentive and benefits.

Company

hirify.global partners with community health centers to help patients maintain coverage, resolve coverage gaps, and access care through insurance distribution, patient workflows, and outreach programs.

What you will do

• Build and refine ACA and Medicare intake, consent, documentation, enrollment, callback, and partner-handoff workflows.
• Take initial ACA and Medicare calls, manage overflow queues, and handle complex patient escalations once properly licensed, certified, appointed, and authorized.
• Recruit, onboard, coach, and track the readiness of licensed seasonal and temp-to-hire agents.
• Train agents on patient-first communication, approved scripts, disclosures, documentation, and role boundaries.
• Review recorded calls, monitor QA trends, coach performance gaps, and escalate compliance concerns.
• Manage Five9 queues, skills, dispositions, call notes, SLAs, and operational feedback while using demand and service data to recommend staffing changes.

Requirements

• Active health insurance producer license in the resident state and willingness to obtain nonresident licenses as needed.
• Ability to obtain appointments with contracted carriers and the FMO, including a release from any prior upline when applicable.
• Willingness to complete 2027 plan-year AHIP certification, FFM registration, and applicable SBE certification before handling live enrollments if not already current.
• At least 3 years of practical ACA Marketplace and/or Medicare experience.
• At least 1 year of experience coaching, supervising, or leading agents in a phone-based enrollment, call center, agency, health plan, or member-service environment.
• Strong knowledge of consent, disclosures, documentation, QA, complaint escalation, compliant enrollment, and cross-functional collaboration.

Nice to have

• Experience across ACA Marketplace and Medicare Advantage, Part D, and Medicare Supplement.
• Current AHIP and Marketplace certifications.
• Experience with Five9, HealthSherpa, Sunfire, EDE platforms, carrier portals, or similar tools.
• Experience with Medicare educational events, clinic on-sites, field-agent workflows, training programs, QA scorecards, dashboards, or launch playbooks.
• Bilingual Spanish/English or other languages aligned with patient needs.

Culture & Benefits

• Remote-first work with minimal travel at launch and occasional travel concentrated around AEP/OEP season.
• Approved business travel, mileage, lodging, remote office and cell expenses, and on-site costs are covered.
• Comprehensive benefits including no-cost employee health, dental, and vision coverage.
• 401(k) policy with an employer match of up to 4%.
• Opportunity to build the operating model and transition from direct call handling to full-time coaching and operations leadership as the team scales.