Job Description

Posting number: 191518

Department: Department of Health and Human Services

Division: Eligibility, Enrollment, and Member Services (EEMS)

Job classification: Eligibility Coordinator I

Posting type: Open

Categories: Administration, Clerical & Data Entry, Accounting and Finance, Health Services, Paraprofessional, Miscellaneous, Human Services, Business, Social Sciences, Office and Administrative Support

Are you the One? We are looking for an Eligibility Coordinator I (EEMS Escalations Supervisor (MAGI)) who serves as Supervisor and is responsible for the leadership and direction of the Tier One Escalation MAGI Escalation Specialists. Responsible for timely and accurate eligibility determinations and positive customer service. Is directly responsible for ensuring team members are held accountable for timely and accurate determinations. Serves as the back up point of contact for the EEMS Escalations Supervisor (MAGI).

• Leads a team of skilled Medicaid Eligibility Specialists, directing the efforts of Specialists and managing work within the team. Monitors team member performance on a day-to-day basis. Implements agency-standard workflow processes and procedures. Provides guidance to team members and agency managers on the effectiveness of agency policies, procedures, and processes. Ensures Specialists are held accountable to established guidelines for the performance of workplace duties.
• Receives and interprets employee performance reports and provides accurate counseling to Eligibility Specialists in a timely manner. Performs correct administrative follow-up activities after employee counseling and consults human resources when needed to complete employee evaluation or disciplinary action. Reviews and assist with identifying staff needs, workforce development opportunities and forecasting training opportunities for staff within the MAGI Escalation Team .Identifies high-performing employees as candidates for reward or promotion. Provides positive reinforcement and messaging to employees about departmental goals and standards. Leads a team that meets, in the aggregate, Medicaid Eligibility Specialist performance standards.
• 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 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. Assists eligibility management and senior leadership with projects as assigned. Performs related duties as assigned or required. Ensures Eligibility Specialists attend and successfully complete all training. Performs and coordinates preparedness/shelter duty activities as assigned.
• Serves as the back up point of contact for the Program Coordinator II, EEMS Escalations Supervisor (MAGI). Works closely with Member Services, Bureau of Managed Care Organization, and Appeals to address opportunities for enhancing customer service. Ensures accurate eligibility determinations and strives to improve stakeholder experience and outcomes. As needed, provides data driven recommendations to leadership of trends and findings, address federal standards of promptness guidance, and strives to increase efficiency and productivity. Collaborate and streamlines with stakeholders and state agencies to ensure all expectations are met.

• 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.

Examples of duties

A high school diploma and relevant program experience.

A bachelor’s degree may be substituted for the required program experience.

Preferred: At least two (2) years of supervisory experience.

Additional Requirements:

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

Qualifications

• Demonstrates sound supervisory personnel actions through efforts to promote equal opportunity.
• Planning Documents must be submitted to the Office of Human Resources within one (1) month of the beginning of an employee’s review period.
• Evaluation Documents must be submitted to the Office of Human Resources prior to the end of the employee’s review period.
• Ensure employee staff development and training is included on all assigned employees’ Planning Documents 100% of the time.
• Personnel actions must be submitted to the Office of Human Resources within at least five business days of the proposed effective date.
• Identifies staffing needs for team on a regular basis.
• Responsible for managing employee leave and attendance according to the Department's Time and Attendance Policy.
• Monitors employee leave balances, documents employee sick leave abuse, excessive absenteeism, and requests for leave without pay for the assigned team.
• Responsible for ensuring that supervisors are provided with guidance on an on-going basis regarding personnel issues.
• Works closely with Human Resource Management regarding personnel issues.

Supplemental 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.