AI Business Automation Project Manager, Health Plan Services

WelbeHealth is a value-based healthcare organization transforming the future of senior care by providing an all-inclusive care option for seniors, keeping them within their communities and cared for like family while receiving necessary healthcare and social services.

Core Responsibilities:

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, identifying inefficiencies, designing practical solutions, and building AI-enabled workflows that improve Health Plan Services operations
• Modernizes 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 team and operational experience

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 improving or implementing systems, tools, and technology for 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 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, setting realistic expectations about capability, accuracy, and risk
• Document project and automation logic clearly for maintainability, handoff, refinement, or governance over time
• Track and report project status, escalate issues, organize project resources, manage over-allocated resources, and motivate teams to complete key deliverables
• Develop relationships with key stakeholders to ensure delivered projects meet business needs and delight customers

Job requirements include:

• A Bachelor’s degree in a 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, focusing on practical business use cases
• 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) 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