Eligibility & Financial Determination Supervisor

Responsibilities

• Provides leadership and works closely with Eligibility and Financial Determination Specialists, conducting case reviews, answering questions, troubleshooting cases, and filling in for staff on PTO or vacant positions.
• Works with each Center and Specialists to stay current on monthly enrollment numbers, assisting with case enrollment decisions and providing alternatives and steps for resolving Medicaid issues.
• Distributes monthly enrollment numbers to Centers and InnovAge staff, updating continuously to reflect recent approvals and cases pending functional assessment.
• Tracks monthly new enrollments with Specialists, following through to approvals and obtaining State IDs.
• Tracks 10-day and denial notices on new enrollments, working to resolution (approval or disenrollment), monitors for underlying themes, and provides training as needed.
• Assists the Eligibility and Financial Determination Controller in maintaining working relationships with Medical Assistance (MA) Sites, including policy and procedure updates, resolving monthly issues, and participating in quarterly face-to-face meetings.
• Participates in the team that distributes incoming faxes to the InnovAge fax line.
• Leads assessment of procedures, policies, and systems; develops and implements quality improvement plans and promotes standardization, best practices, and compliance.
• Keeps current on Federal and State Medicaid rules and regulations, informing staff of changes and their impact on job duties.

Supervision

• Supervises and manages direct reports, providing motivation and direction in accordance with organizational policies and employment laws.
• Helps set departmental tone to maintain morale, teamwork, and a positive employment culture.
• Ensures timely and effective annual employee performance reviews.
• Evaluates employee compliance and contributions to organizational objectives.
• Schedules regular leadership, department, and 1:1 meetings for leadership, development, and communication.
• Handles interviewing, hiring, training, planning, assigning, and directing work.
• Manages performance appraisal, recognition, corrective disciplinary procedures (with supervisor and HR), and complaint resolution.

Required Qualifications

• Associate's Degree from an accredited college or university.
• Minimum one (1) year hands-on experience with the Colorado Benefit Management System (CBMS).
• Minimum three (3) years of experience determining Medicaid LTC eligibility and/or assisting clients through LTC Medicaid applications to approval.
• Minimum three (3) years of experience working with the frail and/or elderly population.
• Strong management skills and at least two (2) years of experience supervising staff.
• Vast and current knowledge of long-term care Medicaid regulations and guidelines.
• Skilled at identifying problems, auditing systems, and implementing corrections and policy changes.
• Skilled in project management and facilitation of work groups, quality improvement, and team meetings.
• Effective working relationships with County and field staff.
• Experience generating and ensuring accurate data and presenting results orally, in writing, and in graphs for technical review.

Preferred Qualifications

• Bachelor's Degree.

Pay

Posted pay range: $60,000 – $75,000. The actual offer will consider geographic region, job-related knowledge, skills, experience, and internal equity, among other factors.

Schedule

FLSA Exemption Status: Exempt.

Benefits

• Medical, dental, and vision insurance
• Short and long-term disability
• Life insurance and AD&D
• Supplemental life insurance
• Flexible spending accounts
• 401(k) savings
• Paid time off
• Company paid holidays