{"schemaVersion":"jobsearcher.job.v1","id":"f60e045bb15f1049a0f6d5e7","url":"https://jobsearcher.com/jobs/f60e045bb15f1049a0f6d5e7","canonicalUrl":"https://jobsearcher.com/jobs/f60e045bb15f1049a0f6d5e7","title":"Manager, Coverage Distribution Operations","description":"Manager, Coverage Distribution Operations\nLocation: Remote / Flexible (Remote-first; headquartered in California, multi-state scope)\nEmployment Type: Full-Time, W-2\nReports to: Head of Patient Operations & Coverage Distribution\nTravel: Minimal at launch, with occasional trips for Medicare clinic events and on-site readiness as field programming scales, concentrated around AEP/OEP season, additional company wide onsites expected quarterly\nSalary: $90,000-100,000 + Performance Incentive + Benefits\n\nAbout Pointcare\nPointcare partners with community health centers to help patients keep coverage active, resolve coverage gaps, and access the care they need. We are expanding that work by building a licensed ACA and Medicare coverage distribution function connected to our existing patient base, clinic relationships, app workflows, service introductions, and outreach programs.\nThis is not a cold-lead insurance sales role. Many patients will be navigating Medicaid loss, Marketplace eligibility, Medicare transitions, dual eligibility, or uninsured/self-pay situations. The right leader will bring strong insurance knowledge, operational discipline, and patient-first judgment.\nAbout the Role\nThe Manager, Coverage Distribution Operations will help build and operate Pointcare’s ACA and Medicare distribution lane. During launch, you’ll work the queue yourself before anyone else does — taking the first ACA and Medicare calls, testing workflows firsthand, and handling escalations, once authorized — so the systems, scripts, and coaching you build are grounded in real calls, not theory. That firsthand credibility is what lets you lead the team you’ll go on to manage.\nAs volume grows, you will shift more time toward coaching licensed agents, monitoring quality, managing insurance-specific workflows, recommending staffing changes, and supporting Medicare field/on-site readiness.\nWhat You’ll Do\nBuild and refine ACA/Medicare intake, consent, documentation, enrollment, callback, and partner-handoff workflows.\nAct as the team’s first producer during launch — taking ACA and Medicare calls, overflow queues, and complex patient escalations yourself (once properly licensed, certified, appointed, and authorized) to build firsthand knowledge of the workflows you’ll manage.\nSupport recruiting, onboarding, readiness tracking, and coaching for licensed seasonal/temp-to-hire agents as the team scales.\nMaintain agent readiness visibility across licenses, AHIP, Marketplace certifications, carrier appointments, ready-to-sell status, and system access.\nTrain agents on patient-first communication, approved scripts, consent, disclosures, call documentation, and role boundaries.\nReview recorded calls, monitor QA trends, coach performance gaps, and escalate compliance concerns appropriately.\nManage insurance-specific Five9 workflows, including queues, skills, dispositions, call-note requirements, SLAs, and workflow feedback.\nUse real data - agent-workable leads, speed-to-lead, backlog, supported states, handling time, and service levels - to recommend when to scale staffing.\nHelp design Medicare clinic-event and on-site playbooks, including approved materials, field logistics, and compliance-aligned execution as field operations expand.\nWhat You’ll Bring\nRequired\nActive health insurance producer license in your resident state, with willingness and ability to obtain nonresident licenses as needed.\nCarrier Appointment Eligibility: Must be able to be appointed with Pointcare’s contracted carriers and FMO. If you hold or have held carrier appointments elsewhere, you must be able to obtain a release from that prior upline. If not already current, you must be willing and able to complete 2027 plan-year AHIP certification, Federally-Facilitated Marketplace (FFM) registration, and any applicable State-Based Exchange (SBE) certification before handling live enrollments.\n3+ years of practical ACA Marketplace and/or Medicare experience.\n1+ years coaching, supervising, or leading agents in a phone-based enrollment, call center, agency, health plan, or member-service environment.\nWillingness to take live calls and lead by example during launch, with the expectation that your time shifts toward full-time coaching and operations as the team scales.\nStrong understanding of consent, disclosures, documentation, QA, complaint escalation, and compliant enrollment practices.\nAbility to work cross-functionally with Patient Operations, Licensing, Contracting, Compliance, IT, and external partners.\nStrongly Preferred\nExperience across ACA Marketplace and Medicare (Medicare Advantage, Part D, and Medicare Supplement).\nCurrent AHIP and Marketplace certifications.\nExperience with Five9, HealthSherpa, Sunfire, EDE platforms, carrier portals, or similar tools.\nExperience supporting Medicare educational/marketing events, clinic on-sites, or field-agent workflows.\nExperience building training programs, QA scorecards, dashboards, or launch playbooks.\nBilingual Spanish/English or other language skills aligned with patient needs.\nBenefits & Employment Details\nTravel is minimal at launch, with occasional trips for Medicare clinic events and on-site readiness as field programming scales, concentrated around AEP/OEP season. Approved business travel, mileage, lodging, remote office/cell expenses, and on-site costs are covered by the company.\nAdditional travel for company wide onsites to be expected quarterly.\nComprehensive benefits package including no cost employee health, dental, and vision coverage.\nGenerous 401(k) policy and employer match of up to 4%.\nFirst 90 Days\nBuild and map workflows, readiness tracking, system needs, and insurance-specific Five9 requirements.\nTrain and test call flows through mock calls, QA calibration, certification tracking, and direct producer work when authorized.\nLaunch and scale live workflows during AEP/OEP, coach agents, monitor service levels, and recommend staffing changes based on actual demand.\nnZMI2C9919","company":"Pointcare","rawCompany":"pointcare","city":"Remote","state":"OR","isRemote":false,"isActive":false,"createdAt":"2026-08-10T15:10:38.475Z","occupations":[{"code":"41-3021.00","title":"Insurance Sales Agents","slug":"insurance-sales-agents"},{"code":"11-9111.00","title":"Medical and Health Services Managers","slug":"medical-and-health-services-managers"},{"code":"13-2053.00","title":"Insurance Underwriters","slug":"insurance-underwriters"}],"industries":[{"code":"524210","title":"Insurance Agencies and Brokerages","slug":"insurance-agencies-and-brokerages"},{"code":"524298","title":"All Other Insurance Related Activities","slug":"all-other-insurance-related-activities"},{"code":"524114","title":"Direct Health and Medical Insurance Carriers","slug":"direct-health-and-medical-insurance-carriers"}],"jobPosting":{"@context":"https://schema.org","@type":"JobPosting","title":"Manager, Coverage Distribution Operations","description":"Manager, Coverage Distribution Operations\nLocation: Remote / Flexible (Remote-first; headquartered in California, multi-state scope)\nEmployment Type: Full-Time, W-2\nReports to: Head of Patient Operations & Coverage Distribution\nTravel: Minimal at launch, with occasional trips for Medicare clinic events and on-site readiness as field programming scales, concentrated around AEP/OEP season, additional company wide onsites expected quarterly\nSalary: $90,000-100,000 + Performance Incentive + Benefits\n\nAbout Pointcare\nPointcare partners with community health centers to help patients keep coverage active, resolve coverage gaps, and access the care they need. We are expanding that work by building a licensed ACA and Medicare coverage distribution function connected to our existing patient base, clinic relationships, app workflows, service introductions, and outreach programs.\nThis is not a cold-lead insurance sales role. Many patients will be navigating Medicaid loss, Marketplace eligibility, Medicare transitions, dual eligibility, or uninsured/self-pay situations. The right leader will bring strong insurance knowledge, operational discipline, and patient-first judgment.\nAbout the Role\nThe Manager, Coverage Distribution Operations will help build and operate Pointcare’s ACA and Medicare distribution lane. During launch, you’ll work the queue yourself before anyone else does — taking the first ACA and Medicare calls, testing workflows firsthand, and handling escalations, once authorized — so the systems, scripts, and coaching you build are grounded in real calls, not theory. That firsthand credibility is what lets you lead the team you’ll go on to manage.\nAs volume grows, you will shift more time toward coaching licensed agents, monitoring quality, managing insurance-specific workflows, recommending staffing changes, and supporting Medicare field/on-site readiness.\nWhat You’ll Do\nBuild and refine ACA/Medicare intake, consent, documentation, enrollment, callback, and partner-handoff workflows.\nAct as the team’s first producer during launch — taking ACA and Medicare calls, overflow queues, and complex patient escalations yourself (once properly licensed, certified, appointed, and authorized) to build firsthand knowledge of the workflows you’ll manage.\nSupport recruiting, onboarding, readiness tracking, and coaching for licensed seasonal/temp-to-hire agents as the team scales.\nMaintain agent readiness visibility across licenses, AHIP, Marketplace certifications, carrier appointments, ready-to-sell status, and system access.\nTrain agents on patient-first communication, approved scripts, consent, disclosures, call documentation, and role boundaries.\nReview recorded calls, monitor QA trends, coach performance gaps, and escalate compliance concerns appropriately.\nManage insurance-specific Five9 workflows, including queues, skills, dispositions, call-note requirements, SLAs, and workflow feedback.\nUse real data - agent-workable leads, speed-to-lead, backlog, supported states, handling time, and service levels - to recommend when to scale staffing.\nHelp design Medicare clinic-event and on-site playbooks, including approved materials, field logistics, and compliance-aligned execution as field operations expand.\nWhat You’ll Bring\nRequired\nActive health insurance producer license in your resident state, with willingness and ability to obtain nonresident licenses as needed.\nCarrier Appointment Eligibility: Must be able to be appointed with Pointcare’s contracted carriers and FMO. If you hold or have held carrier appointments elsewhere, you must be able to obtain a release from that prior upline. If not already current, you must be willing and able to complete 2027 plan-year AHIP certification, Federally-Facilitated Marketplace (FFM) registration, and any applicable State-Based Exchange (SBE) certification before handling live enrollments.\n3+ years of practical ACA Marketplace and/or Medicare experience.\n1+ years coaching, supervising, or leading agents in a phone-based enrollment, call center, agency, health plan, or member-service environment.\nWillingness to take live calls and lead by example during launch, with the expectation that your time shifts toward full-time coaching and operations as the team scales.\nStrong understanding of consent, disclosures, documentation, QA, complaint escalation, and compliant enrollment practices.\nAbility to work cross-functionally with Patient Operations, Licensing, Contracting, Compliance, IT, and external partners.\nStrongly Preferred\nExperience across ACA Marketplace and Medicare (Medicare Advantage, Part D, and Medicare Supplement).\nCurrent AHIP and Marketplace certifications.\nExperience with Five9, HealthSherpa, Sunfire, EDE platforms, carrier portals, or similar tools.\nExperience supporting Medicare educational/marketing events, clinic on-sites, or field-agent workflows.\nExperience building training programs, QA scorecards, dashboards, or launch playbooks.\nBilingual Spanish/English or other language skills aligned with patient needs.\nBenefits & Employment Details\nTravel is minimal at launch, with occasional trips for Medicare clinic events and on-site readiness as field programming scales, concentrated around AEP/OEP season. Approved business travel, mileage, lodging, remote office/cell expenses, and on-site costs are covered by the company.\nAdditional travel for company wide onsites to be expected quarterly.\nComprehensive benefits package including no cost employee health, dental, and vision coverage.\nGenerous 401(k) policy and employer match of up to 4%.\nFirst 90 Days\nBuild and map workflows, readiness tracking, system needs, and insurance-specific Five9 requirements.\nTrain and test call flows through mock calls, QA calibration, certification tracking, and direct producer work when authorized.\nLaunch and scale live workflows during AEP/OEP, coach agents, monitor service levels, and recommend staffing changes based on actual demand.\nnZMI2C9919","datePosted":"2026-08-10T15:10:38.475Z","dateModified":"2026-08-10T15:10:38.475Z","hiringOrganization":{"@type":"Organization","name":"Pointcare","sameAs":"https://jobsearcher.com"},"jobLocation":{"@type":"Place","address":{"@type":"PostalAddress","addressLocality":"Remote","addressRegion":"OR","addressCountry":"US"}},"identifier":{"@type":"PropertyValue","name":"JobSearcher","value":"f60e045bb15f1049a0f6d5e7"},"url":"https://jobsearcher.com/jobs/f60e045bb15f1049a0f6d5e7"}}