Eligibility Coordinator II / 60019449

Full Job Description

Are you the One? We are looking for an Eligibility Coordinator II who, under the direct supervision of the Eligibility Manager for Processing Center operations, serves as Supervisor and is responsible for managing a team of up to 20 LTCW Eligibility staff. Provides leadership and direction to Eligibility team staff. Responsible for timely and accurate eligibility decisions, delivery of services, and customer service. Supports the achievement of performance and operational success for eligibility determination processing.

Leads a team of skilled Medicaid Eligibility specialists in a Medicaid Eligibility Operations Center (MEOC), directing the efforts of Specialists and allocating work within the team.

Assigns Medicaid eligibility applications, reviews, and changes to team members and monitors team member performance on a day-to-day basis.

Implements agency-standard workflow processes and procedures and provides guidance to team members and agency managers on the effectiveness of agency policies, procedures, and processes.

Establishes clear and consistent guidelines for the performance or workplace duties.

Implements Medicaid Eligibility Specialist 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.

Provides technical assistance to Medicaid Eligibility Specialists and aids in the resolution of common questions, concerns, and escalations received by Medicaid Eligibility Specialists.

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

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

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.

Program Manager for Statewide Long-Term Care Eligibility Operations with special projects. 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 professional experience in human services or social services programs.

An equivalent combination of education and experience may be considered with prior State Human Resources approval.

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

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

Qualifications

Extensive knowledge of the Medicaid Program, human services program, or case processing preferred. Supervisory and Management experience preferred.

Ability to analyze and interpret broad health and human service issues and their impact on the Department's programs.

Knowledge of laws, regulations, policies and procedures relevant to the area of employment. Ability to exercise judgment and discretion.

Ability to establish and maintain effective working relationships. Ability to effectively manage time and prioritize tasks and projects with competing and/or shifting deadlines.

Must be able to lead and manage a diverse staff.

Ability to communicate and collaborate with staff from different levels of the workforce.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.