Eligibility Coordinator II / 60013849

Full Job Description

Are you the One? We are looking for an Eligibility Coordinator II who acts as liaison between the Department of Health and Human Services (the Department), Eligibility, Enrollment,
& Member Services (EEMS) and the South Carolina Department of Vocational Rehabilitation (SCVR) State claims office. Provides support and statewide assistance to eligibility workers, recipients, and the leadership team for both agencies regarding the independent disability application process. This includes the review of all disability applications/forms prior to submitting to state claims for a medical determination. Acts as a liaison between Medically Indigent Assistance (MIAP) Coordinators located in county facilities and DHHS. Responsible for managing and training staff dedicated to the unit.

Oversees, manages, and coordinates communication, staff training and quality improvement efforts at SC Vocational Rehabilitation to ensure disability packets submitted by eligibility workers are accurate according to the Medicaid policy and procedures.

Works independently, as well as a member of a team to provide complete and appropriate oversight of all DHHS staff located in the office of state claims at SC Vocational Rehabilitation.

Assists with hiring, training, and monitoring attendance for the unit's staff. Responds to emails from management and appeals providing status updates on cases pending from VR or the Department.

Researches/resolves problem issues.

Manages and coordinates communication, staff training, and quality improvement for the DHHS MIAP team.

Establishes and maintains cooperative working relationships with county designees, staff members, and stake holders to ensure established goals are met and problems resolved.

Maintain the case records for all MIAP applications for a period of 6 years after the end of the State fiscal year.

Establishes and maintains cooperative working relationships with SC Vocational Rehabilitation staff members, coordinators, executive administrators, and stakeholders to ensure established goals are met and problems resolved.

Demonstrates strong interpersonal skills in collaborating with coworkers and the public to provide service.

Provides feedback on ways to combine, consolidate and centralize the disability workflow to maximize efficiency and support the agency's restructuring plan for process improvement.

Implements performance standards in accordance with departmental policies and guidelines.

Provides monthly, quarterly, annual, and as-needed written and verbal counseling to teammates to explain each team member’s performance relative to departmental standards.

Assists team members with workplace action plans to ensure each team member can meet departmental standards for the timeliness and accuracy of eligibility determinations.

Periodically spot-checks worker performance with respect to attendance, productivity, completeness of application workbooks, and accuracy of determinations.

Provides technical assistance to management team and appeals to aids in the resolution of common questions, concerns, and escalations received by Medicaid Eligibility Specialists and/or Vocational Rehabilitation.

Accurately addresses or routes questions and escalations to the appropriate resource including team leads, training staff, or help desk professionals, among others.

Performs fundamental supervisory and leadership functions in accordance with Department policies and procedures, best practices and Federal and State rules and regulations, especially with regard to Equal Employment Opportunity Commission (EEOC) standards.

Maintains an effective organizational team and motivates diverse staff to accomplish mission critical operations and objectives.

Promotes workforce engagement and a safe, professional, and productive work environment for all employees.

Attends meetings and training sessions as required. Makes and keeps schedules, completes tasks timely and reports to work timely. Performs related duties as assigned or required.

Ensures staff attends and successfully completes all training. Performs and coordinates preparedness/shelter duty activities as assigned.

The South Carolina Department of Health and Human Services offers an exceptional benefits package for FTE and TGE positions that includes:

• Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children.
• 15 days annual (vacation) leave per year.
• 15 days sick leave per year.
• 13 paid holidays.
• State Retirement Plan and Deferred Compensation Programs.

Requirements

A bachelor's degree and one (1) year of Medicaid Eligibility experience processing SSI related cases/eligibility and resolving issues associated with independent Medicaid disability applications.

Preferred: At least two (2) years working in Medicaid related programs and at least four (4) years of experience in management and leadership roles, directly responsible for program outcomes and creating solutions for improved performance.

Additional Requirements

• Occasional overnight travel.
• Valid driver's license.
• Requires holder to drive routinely.
• Overtime and/or weekend work with Deputy approval.
• Sitting or standing for long periods of time.
• Lifting requirements: 20lbs.

Qualifications

• Ability to communicate effectively and professionally and to collect and assemble information in a clear and concise manner with the general public, fellow employees, and other entities.
• Ability to exercise good judgment, provide effective and efficient customer service and discretion.
• Must have proficient communication skills both verbal and written, basic computer skills, organizational skills, and manage time effectively.
• Ability to work independently, as well as with a Team and maintain effective and harmonious working relationships.
• Ability to interpret and apply Medicaid policies and procedures.

This position is accountable for managing a unit responsible for customer service that have impact on both the financial well-being of the State and the availability of resources to provide healthcare to the State's needy citizens.

Employee must be able to make frequent independent decisions, work independently, and use discretion with only limited supervision.

Additional Information

Please complete the State application to include all current and previous work history and education.

A resume will not be accepted nor reviewed to determine if an applicant has met the qualifications for the position.

Supplemental questions are considered part of your official application for qualification purposes. All applicants must apply online.

All correspondence from the Office of Human Resources will be through electronic mail.

The South Carolina Department of Health and Human Services is committed to providing equal employment opportunities to all applicants and does not discriminate on the basis of race, color, religion, sex (including pregnancy, childbirth or related medical conditions, including, but not limited, to lactation), national origin, age (40 or older), disability or genetic information.