What are the responsibilities and job description for the Benefits and Eligibility Supervisor position at EO of HHS PayRoll/Gen Admin?
MassHealth Operations (MHO) is seeking a dynamic and experienced supervisor for the role of Benefits and Eligibility Supervisor. The selected candidate will lead a team of customer service professionals in determining applicant eligibility for health care benefits. As an expert internal resource, the incumbent will determine applicant eligibility, interpret policy, mentor and train staff.
Duties and Responsibilities (these duties are a general summary and not all inclusive):
- Supervise a team of customer service professionals who determine applicant eligibility for MassHealth benefits.
- Provide subject matter expertise as an internal resource by assisting subordinate staff in interpreting policy.
- Determine initial and ongoing eligibility for certain MassHealth populations and facilitates the accurate and timely determination of initial eligibility by explaining requirements and following up with applicant(s) who do not submit required verifications.
- Communicate with applicant(s) and/or their authorized representatives to explain programmatic requirements for all Mass Health programs.
- Input applicant data into agency’s computer system to establish and update applicant data, validates data, and make corrections on agency computer system.
- Validate applicant demographic, financial and background data by contacting applicant to obtain information not listed on eligibility forms, contacts collateral sources and determines immigrant status by reviewing immigrant documentation.
- Represent agency at hearings by preparing and delivering explanations of eligibility determinations, and explains appeal rights and procedures to applicants, attorneys, advocates, providers, public officials, and the general public.
- Provide requested services and makes appropriate referrals to internal and external programs for which applicants may qualify, and acts as liaison to selected groups.
- Provide quality customer service by responding to all customer inquiries in a professional, efficient and courteous manner.
- Assist the Team Manager in implementing MassHealth Enrollment Center (MEC) and Central Office initiatives; assigning, reviewing and monitoring work; collecting and reporting statistics; staff scheduling; and monitoring time and attendance.
- Assist the Team Manager in developing team members’ skills through training and interpreting agency policies and in developing workflow procedures and communicates with team members to share information to improve performance.
- Provide back up to Team Manager and in the Team Manager’s absence, represents the Team Manager where appropriate including difficult case situations.
- Complete special projects in accordance with agency directives, including statistical and narrative reports to track and evaluate office performance.
- Perform related work as required including but not limited to: contacting applicants by phone, maintaining and updating policy and procedures manuals, attending staff meetings and training sessions and completing special projects in accordance with agency directives.
Preferred Qualifications:
- Prior supervisory experience in a fast-paced, customer service environment.
- Active, empathetic listener with strong writing and verbal communications skills.
- Genuine service-orientated individual with a commitment to effective customer service and concern for others’ needs.
- Keen attention to detail; the ability to research and analyze complex financial, tax and insurance documents; capacity to assess the value of assets and income.
- Sound judgment with an aptitude to keep composed in difficult situations.
- Proficient usage of Microsoft Office products including Outlook, Word, and Excel.
Required Qualifications:
Identification of Key Causes: Identifying the things that must be changed to achieve a goal.
Identifying Downstream Consequences: Determining the long-term outcomes of a change in operations.
Implementation Planning: Developing approaches for implementing an idea.
Making Decisions and Solving Problems: Combining, evaluating, and reasoning with information and data
About MassHealth:
To improve the health outcomes of our diverse members and their families by providing access to integrated health care services that sustainable & equitable health, well-being, independence, and quality of life.
For more information about our agency and programs please visit: www.mass.gov/masshealth
Pre-Offer Process:
A criminal background check will be completed on the recommended candidate as required by the regulations set forth by the Executive Office of Health and Human Services prior to the candidate being hired. For more information, please visit http://www.mass.gov/hhs/cori
Education, licensure and certifications will be verified in accordance with the Human Resources Division’s Hiring Guidelines.
Education and license/certification information provided by the selected candidate(s) is subject to the Massachusetts Public Records Law and may be published on the Commonwealth’s website.
If you require assistance with the application/interview process and would like to request an ADA accommodation, please click on the link and complete the ADA Reasonable Accommodation Request Form.
For questions, please the contact the Office of Human Resources at 1-800-510-4122 and select option #4.
TO APPLY:
Please upload both Resume and Cover Letter for this position when applying.
Qualifications
First consideration will be given to those applicants that apply within the first 14 days.
MINIMUM ENTRANCE REQUIREMENTS:
At least five years of full-time, or equivalent part-time, professional experience in social work or social casework, claims adjudication, job placement, recruitment, employment counseling, vocational or rehabilitation counseling, credit investigation, educational counseling, legal advocacy, or legal counseling. Based on assignment to second-level supervisory positions, at least one year of this experience must have been in a supervisory capacity.
SUBSTITUTIONS:
Based on assignment, travel may be required. Those employees who elect to use a motor vehicle for travel must have a current and valid Massachusetts Motor Vehicle Operator's license or the equivalent from another state.
First consideration will be given to those applicants that apply within the first 14 days.
MINIMUM ENTRANCE REQUIREMENTS:
At least five years of full-time, or equivalent part-time, professional experience in social work or social casework, claims adjudication, job placement, recruitment, employment counseling, vocational or rehabilitation counseling, credit investigation, educational counseling, legal advocacy, or legal counseling. Based on assignment to second-level supervisory positions, at least one year of this experience must have been in a supervisory capacity.
SUBSTITUTIONS:
- A Bachelor's or higher degree may be substituted for two years of the required non-supervisory experience on the basis of two years of education for one year of experience.
- One year of education equals 30 semester hours. Education toward a degree will be prorated on the basis of the proportion of the requirements actually completed.
- No substitutions will be permitted for the required supervisory or managerial experience.
Based on assignment, travel may be required. Those employees who elect to use a motor vehicle for travel must have a current and valid Massachusetts Motor Vehicle Operator's license or the equivalent from another state.
**Salary placement is determined by a combination of factors, including the candidate’s years of directly related experience and education, and alignment with our internal compensation structure as set forth by the Human Resources Division’s Hiring Guidelines. For all bargaining unit positions (non-management), compensation is subject to the salary provisions outlined in the applicable collective bargaining agreement and will apply to placement within the appropriate salary range.
Comprehensive Benefits
When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.
Want the specifics? Explore our Employee Benefits and Rewards!
An Equal Opportunity / Affirmative Action Employer. Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.
The Commonwealth is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity or expression, sexual orientation, age, disability, national origin, veteran status, or any other basis covered by appropriate law. Research suggests that qualified women, Black, Indigenous, and Persons of Color (BIPOC) may self-select out of opportunities if they don't meet 100% of the job requirements. We encourage individuals who believe they have the skills necessary to thrive to apply for this role.
Official Title: Ben Elig & Ref Soc Wrker (D)
Primary Location: United States-Massachusetts-Quincy - 100 Hancock Street
Job: Community and Social Services
Agency: Exec Office Of Health and Human Services
Schedule: Full-time
Shift: Day
Job Posting: Mar 6, 2025, 9:31:48 AM
Number of Openings: 1
Salary: 76,134.76 - 104,052.78 Yearly
If you have Diversity, Affirmative Action or Equal Employment Opportunity questions or need a Reasonable Accommodation, please contact Diversity Officer / ADA Coordinator: Kendy Derival, Kendy.Derival3@mass.gov - 6173488456
Bargaining Unit: 08-SEIU - Local 509 - Social/Rehabilitation
Confidential: No
Potentially Eligible for a Hybrid Work Schedule: Yes
