Centralized Appeals Unit - Senior Manager

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Department

Medicaid Support

Job Summary

Job Description

• 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.
• Ensure that project 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.
• Assemble and provide 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.
• 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 agency in conducting needs assessment / consultation for training of eligibility staff. Conduct conferences or counseling sessions with coordinators who may be lacking in work productivity.
• Develop 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 Medicaid.
• 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.
• Handle 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.
• Serves as product or business owner for all future modules designed and implemented for the Centralized Appeals Unit.
• Leads future appeal initiatives at the directive of the Department working with internal and external management, vendors and stakeholders.
• Develop long and short range plans for CAU staff retention and perform gap analysis to minimize negative impacts to the Unit for all projects related to CAU.
• Other tasks as directed.

QUALIFICATIONS

REQUIRED :

DESIRED :

Required Attachments

Please upload the following documents in the Resume / Cover Letter section.

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Posting Close Date

This position will remain open until filled.

Note to Applicant :

Applicants should fully describe their qualifications and experience with specific reference to each of the minimum and preferred qualifications in their cover letter. The search committee will use this information during the initial review of application materials.

References will be contacted at the appropriate phase of the recruitment process.

This position may require a criminal background check to be conducted on the candidate(s) selected for hire.

As part of the hiring process, applicants for positions at the University of New Orleans may be required to demonstrate the ability to perform job-related tasks.

The University of New Orleans is an Affirmative Action and Equal Employment Opportunity employer. We do not discriminate on the basis of race, gender, color, religion, national origin, disability, sexual orientation, gender identity, protected Veteran status, age if 40 or older, or any other characteristic protected by federal, state, or local law.