EEMS Escalation Supervisor I (LTC) (Eligibility Coordinator I) / 60015792

Posting number: 191593

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, Health Services, Management, Paraprofessional, Human Services, Business

Summary

Are you the One? We are looking for an EEMS Escalation Supervisor I (LTC), who will serve as Supervisor and is responsible for the leadership and direction of the Tier One Escalation LTCW 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 (LTC).

• 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 LTC 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 (LTC). 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 Ch