What are the responsibilities and job description for the Eligibility Manager (Troy, MI) position at BeneSys, Inc.?
Eligibility Manager (Troy, MI)
Summary
Coordinates Eligibility Department activities and special projects, with a focus on optimizing operations and managing a high call volume environment. The Eligibility Manager supervises staff to ensure adherence to company policies and procedures, oversees customer service operations, drives process improvements, and leads automation efforts to streamline tasks.
Essential Duties and Responsibilities in Manager Role include but not limited to
Personnel Policies and Procedures - The Manager is responsible for ensuring that employees follow the organization’s policies and procedures, supervising staff in accordance with these guidelines. This includes scheduling staff for daily operations, managing vacation scheduling, assigning overtime, and ensuring proper backup during employee absences.
Staffing - Regularly reviews department needs, assists in conducting interviews and testing with HR, and provides documented feedback on each candidate. Works with the Eligibility Director to assess appropriate staffing levels and address operational demands, including high call volume management.
Employee Training and Development - Ensures that new employees are properly oriented and receive the necessary training to excel in their roles. Develops tailored training plans to help staff build the expertise required to perform their duties and continuously improves training programs. Provides ongoing coaching and feedback, fostering career development and ensuring readiness to handle both routine tasks and escalated customer service situations.
Employee Performance Management - Sets performance standards and ensures employees meet productivity and quality goals. Reviews and updates job descriptions regularly and conducts performance appraisals to assess employee effectiveness. Provides feedback, implements performance improvement plans when necessary, and rewards top performers. Manages staff performance in alignment with operations goals, including efficiency in a high-call volume environment.
Operations Management and Process Improvement - Leads the coordination of department activities and special projects with an emphasis on operational excellence. Identifies opportunities for process improvements and works with the team to implement automation solutions. This includes analyzing workflows, streamlining tasks, and integrating technology to reduce inefficiencies in daily operations. Responsible for ensuring the department is meeting productivity and quality goals.
Client and Member Escalations - Ensures that client and member escalations are handled professionally and in a timely manner. Investigates and addresses any system, personnel, or procedural issues and creates corrective action plans to prevent recurrence. Uses customer service management expertise to maintain high levels of satisfaction, even during stressful or high-volume times.
High Call Volume Management - Manages and ensures the eligibility team is equipped to handle a high volume of phone calls, including managing difficult or irate callers. Ensures operational efficiency by improving call-handling processes, training staff to maintain composure under pressure, and optimizing team workflows to keep response times as short as possible.
Automation and Technology Integration - Works closely with the Continuous Improvement Team to assess and implement automation enhancements and system updates. Leads efforts to incorporate technology into the eligibility process to improve accuracy and speed. Ensures that the staff is using the most up-to-date tools and technologies for managing eligibility-related tasks.
Additional Responsibilities
- Communicates regularly with Plan Management, Department Managers and Directors to align on departmental goals and strategies.
- Attends outside client functions as necessary, ensuring the company maintains strong customer relationships.
- Evaluates department processes and recommends needed changes based on operational analysis.
- Oversees documentation of all department practices and procedures to ensure consistency and compliance.
Essential Duties and Responsibilities Specific to Eligibility Department include but not limited to
- Ensure staff is following eligibility rules as outlined in the SPD for each fund.
- Oversee the completion of month-end tasks, including reports, status slips, and enrollment forms.
- Ensure the accuracy and timely distribution of enrollment packages and ID cards.
- Verify legal documents for accuracy and compliance with eligibility rules.
- Maintain a thorough understanding of COBRA regulations and ensure the team is trained accordingly.
- Work closely with the IT and CI teams to resolve programming, automation, and system-related issues.
- Continuously evaluate and improve eligibility processes through ongoing staff training and process optimization.
- Coordinate client and union training sessions to ensure clients are fully informed about eligibility procedures.
- Regular and predictable attendance is an essential function of this job.
QUALIFICATIONS
- Skills: Strong leadership and management skills with a focus on team development, coaching, and performance management. Ability to handle high call volumes while maintaining composure and delivering exceptional customer service.
- Operational Expertise: Experience in managing departmental operations, overseeing customer service teams, and implementing process improvements to ensure productivity, quality, and timely service delivery.
Education and/or Experience
- Bachelor’s degree in Business Management or a related field is preferred.
- Experience in operations management, customer service management, and process improvement within a high-call volume environment is highly desirable.
- At least 5 years in an operational management position with a proven track record of success in employee and client retention and satisfaction. Demonstrated success in process improvement, including the ability to assess, enhance, and automate workflows to improve operational efficiency.
Language Skills - Ability to read and interpret the eligibility rules as outlined in the SPD’s, user manuals, department procedures, and COBRA compliance manuals. Must be able to communicate effectively with employees, members, and clients.
Reasoning Ability - Strong analytical skills for identifying operational inefficiencies, troubleshooting issues, and improving processes.
Work Environment - The work environment is fast paced with high call volumes, and employees must be able to maintain composure when managing difficult callers. Most work is done independently, and a focus on managing processes and workflow efficiently in a high-demand environment is crucial.
Work Schedule - Full time. Monday - Friday, 7:30am – 4:30pm. Required in office (No at-home days).
Competitive Benefits and Compensation Package
- 15 days Paid Time Off (PTO) during first full calendar-year of service
- 12 paid holidays
- 3 days paid bereavement
- Up to 20 days paid jury leave
- Medical, dental, and vision insurance, with option for dependent coverage
- Company-paid basic life, short-term disability, long-term disability, and AD&D insurance
- 401k with employer match
- Tuition reimbursement program
- Career development opportunities
- Referral bonus for all successful full-time referrals
- Annual opportunities for increases
Pay - Actual rate dependent on location, skills, education, experience and other business factors.
Our Culture
BeneSys wants to be a great service provider to the members we serve, and we recognize we can only do that if we are also a great employer with successful employees. In short, our success is driven by our employees’ successes. We want to be a place where people want to work, feel proud of what they do and feel fulfilled both professionally and personally. We want to create a place where employees can find long-term growth and potential.
Our culture focuses on three core values:
- Collaboration: working together across 31 locations to achieve the best for the company and our clients
- Dedication: striving to create an environment where all employees work toward a common goal while committing to providing the best customer service to our members and our colleagues
- Integrity: doing what we say we will do. Upholding strong ethical and moral principles
ADA & EEO
Reasonable accommodations will be made so that qualified individuals with disabilities are able to complete the application process and, if hired, fulfill the essential functions of their job.
