This position is primarily responsible for overseeing and managing operations of designated facilities and medical assistance site staff. This position is also responsible for ensuring that the Eligibility Advocates and Enrollment Specialist are in accordance with Kemberton policies and procedures and facilitating meetings with clients to understand their expectations and address any concerns that they may have by performing the following duties.
PRIMARY DUTIES AND RESPONSIBILITIES MAY INCLUDE ANY OR ALL OF THE FOLLOWING:
- Manages Eligibility Advocates, and/or Enrollment Specialists which includes administrative duties such as:
- Training on Kemberton policies and procedures
- Addressing personnel issues
- Preforming annual and 30,60,90 reviews
- Hiring and terminating
- Conduct monthly individual and team meetings
- Understands and performs all general responsibilities of an Eligibility Advocate and/or Enrollment Specialist and provide coverage when needed.
- Management of the medical assistant site staff
- Works with Eligibility Advocates, and/or Enrollment Specialists to ensure accounts are being worked according to Kemberton protocol and facility expectations.
- Meets with designated facilities regularly to address and resolve any concerns according to Kemberton protocol as well as updates them on company operations at their facility.
- Manages caseload issues as they arise to ensure timeliness in cases being worked.
- Meet monthly with Client Director regarding the operations of the team.
- Consults with Client Director regarding any employee/facility concerns in order to resolve them in a timely manner.
- Travels to designated facilities, as needed.
- Assists Eligibility Advocates, as needed, in appealing necessary cases.
- Acts as a Liaison between Social Services and other agencies and the company.
- Attend performance enhancing seminars, as needed.
- Complies with all state and federal regulations and company policies including, but not limited to, attendance, performance, patient privacy, system security and safety.
- Maintains expertise levels on all third party eligibility payers and proves the greatest medical financial risk management available to our patients, providers, and payers.
- Shows a commitment to company values.
- Demonstrates knowledge of company protocol and procedures.
- Possesses strong understanding of Third Party Eligibility Service Operations as defined by scope of project.
Directly supervises employees in the Operations Department to include Eligibility Advocates, and Enrollment Specialist staff, as well as manager medical assistance site staff. Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
- Office environment with some exposure to external environment, temperature changes, uneven walking services.
- Talking: Frequently conveying detailed or important instructions or ideas accurately, clearly, or quickly.
- Hearing: Able to hear average or normal conversations and receive ordinary information.
- Repetitive motion: Frequent and regular use of the wrists, hands, and fingers to make small movements such as typing or picking up small objects. Normal fine and gross motor control of fingers and hands.
- Seeing: Visual acuteness necessary for the proper evaluation of or to prepare, inspect documents or other materials. Ability to accurately view computer monitors.
- Physical: Frequent sitting, standing and walking. Occasional lifting up to 25 lbs, pushing and pulling up to 45 lbs. Occasional kneeling, stooping, and bending at the waist.
- Flexibility with regard to traveling.
- Valid driver's license
- Excellent communication, poise, and problem-solving skills are required.
- Demonstrates a high level of compassion toward our patients
- Demonstrates initiative to accomplish tasks in an independent and timely fashion
- Demonstrates an ability to adapt to changes easily
POSITION QUALIFICATIONS AND REQUIREMENTS:
- Bachelor's degree (B. A.) from four-year college or university; or three to four years related experience and/or training; or equivalent combination of education and experience. Possesses personnel management experience
- 3 - 5 years management experience within the Medicaid Eligibility field.
Knowledge, Skills, Abilities and Competencies:
- Bilingual Spanish capability is a plus.
- Customer Service - Manages difficult or emotional customer situations; Responds promptly to customer needs; Solicits customer feedback to improve service; Responds to requests for service and assistance; Meets commitments.
- Oral Communication - Speaks clearly and persuasively in positive or negative situations; Listens and gets clarification; Responds well to questions; Demonstrates group presentation skills; Participates in meetings.
- Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information.
- Ethics - Treats people with respect; Keeps commitments; Inspires the trust of others; Works with integrity and ethically; Upholds organizational values.
- Planning/Organizing - Prioritizes and plans work activities; Uses time efficiently; Plans for additional resources; Sets goals and objectives;
- Quality - Demonstrates accuracy and thoroughness; Looks for ways to improve and promote quality; Applies feedback to improve performance; Monitors own work to ensure quality.
- Quantity - Meets productivity standards; Completes work in timely manner; Strives to increase productivity; Works quickly.
- Adaptability - Adapts to changes in the work environment; Manages competing demands; Changes approach or method to best fit the situation; Able to deal with frequent change, delays, or unexpected events.