Supervisor, Eligibility

2321

Remote?: 1

Highlights (Bonus, shift, relocation, info for job):

Job Summary 

 

The Supervisor of Eligibility oversees the Eligibility team, ensuring efficient and effective outreach to our members with an insurance barrier or a future barrier.  The role reports directly to the Director of Member Relations and Operations and is responsible for program and team development. The Supervisor assists the Director in the creation and execution of outreach strategies related to member eligibility, with the goal of member retention. The role involves supporting the Eligibility Specialists in day-to-day duties of providing direct outreach, education, and assistance to members to maintain or regain their referring insurance coverage. The Supervisor will lead, manage, and support the team as needed in retention efforts, including direct outreach to members to meet or maintain retention goals.  

 

Duties and Responsibilities 

 

• Define eligibility workflows, job aids, tools, technology, individual and team key performance indicators and reporting. 

• Develop and implement strategies to improve outreach effectiveness and member retention.  

• Evaluate team performance metrics, ensuring quality and efficiency are maintained.  

• Participate in the selection process, recommend candidates for hire, and oversee staff onboarding and training.  

• Lead, mentor, and motivate team members to achieve their individual goals and outcomes.  

• Collaborate across shared services and center functional areas to influence and create structure for the Eligibility program design and strategy. 

• Act as the primary point of contact for the market teams, sharing data and reporting and collecting feedback. 

• Address operational challenges promptly and implement effective solutions. 

• Serve at the eligibility program SME understanding caid/care processes and supporting team in navigating complex cases  

• Monitor implementation of changes to workflows and coach team members through the change. 

• Aggregate and analyze data and information using internal tools, surveys, and available data to gather insights and propose actionable process improvements or program development. 

• Evaluate adherence to Member Relations policy and procedures across all markets. 

• Draft and maintain up to date Member Relations policies and procedures, job aids, training content, and program descriptions. 

• Implement program structure in all local markets, working in collaboration with local market teams  

• Define and measure program outcomes, adjusting program strategy as needed to achieve organizational outcomes  

• Participate in the selection process and recommend candidates for hire. 

 

Minimum Qualifications 

• Associates degree required 

• Bachelor’s degree in healthcare administration, public health, or a related field preferred. 

• 2+ years with Medicaid, Medicare, and/or health plan coverage and eligibility requirements, e.g., state or federal Medicare/Medicaid agency or health plan eligibility experience 

• 1+ years’ experience in serving the needs of complex populations in a health care setting and working directly with members   

• 1+ years of experience in a supervisory or leadership role. 

• Good computer skills including Microsoft Office Suite (Outlook, Excel, PowerPoint, Word) and electronic medical record documentation required.   

• Excellent written and oral communication skills and the ability to work closely with co-workers, patients, family members, and State agencies. 

• Experience in Medicaid eligibility and application processes. 

• Experience and passion for working with and engaging vulnerable, hard to engage, complex populations.   

• Independent and persistent self-starter   

 

Working conditions 

 

This job operates in a remote location from your home location.  This role requires a dedicated, quiet workspace with the ability to adhere to HIPPA and other privacy policies.  A reliable and high-speed Wi-Fi connection or home internet is required to perform the essential functions of this role.   

 

Physical requirements 

 

• Ability to remain stationary for extended periods while working at a desk or workstation. 

• The role requires frequent use of a computer, including typing on a keyboard and using a mouse. Manual dexterity and hand-eye coordination are essential for efficiently completing tasks and navigating various software systems. 

 

Direct reports 

 

(Lead) Eligibility Specialists 

Why Work at AbsoluteCare?

At AbsoluteCare, we serve the most vulnerable individuals in America. These are our neighbors, people who are at higher risk for disease or who have multiple, complex, chronic illnesses. Often, they deal with an unequal healthcare system and wind up seeking basic care from emergency rooms. We take these patients out of those spaces and turn them into members: people who are entitled to some of the best, most focused care this country has to offer. 

We call this “care beyond medicine.” We have turned the doctor’s office into a comprehensive care center. Here, we surround our members with a core care team of doctors, nurses, social workers, and medical assistants who have the time and skills to get to know our members’ needs. We make the most important services available to our members under one roof. This includes a pharmacy, X-rays, a blood lab, nutrition services, urgent care, and much more.

We don’t stop at our four walls. We engage members in the communities where we all live to find the people who need us most. Through these community care teams, we remove the barriers to healthcare that so many people face daily. And it works. 

Our unique care is guided by our core values of accountability, caring, trust, and teamwork. We call it ACT².

AbsoluteCare, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, age, disability, genetics, protected Veteran status, or any other characteristic protected by law or policy.

EEO Employer Verbiage: AbsoluteCare, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, age, disability, genetics, protected Veteran status, or any other characteristic protected by law or policy.