Eligibility Coordinator

Eligibility Coordinator I

The Agency's mission is to be boldly innovative in improving the health and quality of life for South Carolinians. This position is located in Localized Eligibility Processing (LEP), Georgetown County. This is an in-office role and not a telecommute or remote position. Are you the One? We are looking for an Eligibility Coordinator I who serves as Supervisor and is responsible for managing a team of Eligibility Specialists.

Provides leadership and direction to eligibility team staff. 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.

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. Identifies and schedules trainings for employees and 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 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. 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.

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.

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:

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

Extensive knowledge of the Medicaid Program, human…