Centralized Appeals Unit - Supervisor

• Manage and report on all daily activities within the Eligibility Unit. Conduct Quarterly meetings with Coordinator 2s and meet with the entire group as needed when new policy or procedures have been implemented.
• Perform random quality control reviews of work documents to ensure a high level of integrity of the work output.
• Monitors project deadlines to confirm deadlines are met and provide assistance to subordinate staff regarding daily operation and project issues.
• Assist in the development of standards, procedures, and best practices, including internal department documentation, to ensure efficient and effective division operations. Maintain Unit manuals/documents and ensure they remain current with the latest updates and clearances.
• Assist with assembling and providing statistical measurements to LDH regarding Unit’s work output and productivity efforts, this may be completed monthly, quarterly, yearly or at any time upon request from LDH or UNO.
• May act as point of contact to Medicaid personnel regarding current and future Eligibility unit projects and change requests. Work with LDH to ensure cases are processed correctly prior to appeal hearing.
• Assist the CAU Senior Manager in conducting needs assessment/consultation for training of eligibility staff. Conduct conferences or counseling sessions with coordinators who may be lacking in work productivity.
• Assists the CAU Senior Manager with developing long and short range plans for the Eligibility staff’s organization, training, and equipment needs. Trouble shoot equipment needs if possible and report any needed replacements.
• Disseminate all pertinent information to staff through verbal and written communication.
• Complete special eligibility quality control research projects as assigned by the CAU Senior Manager.
• Review changes to Medicaid policy and procedures and disseminate information to staff. This will involve attending meetings with LDH Medicaid staff and provide written process changes to the Unit.
• Interpret and apply complex federal, state, agency policies. Provide guidance on case reviews, handling of appeal requests and request policy clearance when necessary.
• Maintain knowledge of all current Medicaid policies, programs and procedures and ensure new changes, updates or clearances are applied accordingly.
• Maintain knowledge and usage of all verification systems the agency has access to establish eligibility and SharePoint sites for maintaining internal records.
• Learn and maintain knowledge of all employees’ duties and provide back up if someone is out. Process assignments in order to meet Agency Regulation deadline or upon LDHs request and represent the agency on a hearing as required.
• Assist the CAU Senior Manager with handling inquiries forwarded from the Governor’s office and/or forwarded from LDH regarding upset citizens wanting to appeal the denial of Medicaid benefits or requesting updates on their case and report results back to LDH.
• Provide customer service to Medicaid applicants or enrollees who may be upset about being denied coverage and resolve any issues.
• Conduct an annual performance evaluation for each subordinate, setting future goals and strategies.
• Conduct recruitment, interviews, selection, training, supervision, and professional development of assigned staff.
• Work with LDH and UNO policy trainers to ensure new employees are properly trained and provide continuous training to current employees.
• Other tasks as directed.

QUALIFICATIONS
REQUIRED:

• Bachelor's degree, or an Associate's degree plus three years of professional experience, or six years of professional experience in lieu of degree.
• Minimum three years of professional experience with Medicaid appeals processes and procedures.
• Minimum three years professional experience with Medicaid eligibility including MAGI, Non-MAGI, Long Term Care and HCBW programs.
• Minimum two years of supervisory experience.
• Excellent analytical skills, effective organizational and time management skills
• Great attention to detail and follow up, and verbal/written communications skills.
• Works well both independently and as part of a team.
• Ability to set, follow, and meet deadlines.
• Proficient in the use of Adobe Acrobat Pro as well as Microsoft Office Suite (Word, Excel, PowerPoint, and Outlook).

DESIRED:

• Advanced degree.
• Minimum four years of professional experience with Medicaid appeals processes and procedures.
• Minimum four years professional experience with Medicaid eligibility including MAGI, Non-MAGI, Long Term Care and HCBW programs.
• Minimum four years of professional experience working in the Medicaid eligibility system LaMEDS.
• Minimum three years of supervisory experience.