Senior Care Enrollment and Eligibility Lead
Company: Fallon Health
Posted on: March 27, 2020
* Oversees workload of assigned team
* Collaborates with the manager on the daily workload, current
assignments of team members and required adjustments (of staff and
assignments) to meet business needs.
* Ensures team has appropriate resources and highlights areas of
need to manager for resolution.
* Reviews staff schedules (scheduled hours, time off, etc.) with
manager to ensure adequate coverage is provided.
* Raises concerns to the manager regarding issues that may affect
the work environment, team or individual performance. Participates
in implementing solutions as appropriate.
* Serves as subject matter resource for the team
* Acts as a senior resource person/subject matter expert for team
members in all areas of the work, including but not limited to:
application of appropriate policy and procedures, etc.
* Assists the team in resolving routine operational issues as they
arise. Serves as second level escalation with internal and external
customers as necessary to resolve issues.
* Acts as a point of contact and resource for the team.
* Assists with complex issues that fall within existing policy and
procedures. Escalates to manager when appropriate.
* Promotes use of established practices and procedures.
* Participates in training and developing team
* Participates in the orientation of new staff.
* Assists with training and mentoring staff on the application of
policy and procedures, documentation requirements, best practices,
escalation requirements, use of supporting systems/applications,
time management skills, etc.
* Monitors work for efficiency, effectiveness and quality,
including conducting audits as requested by the manager.
* Provides feedback to the manager on team members performance
achievement of goals and deliverables and assessment of
* Assists the Department Managers with developing and implementing
processes and/or procedural improvements or changes.
* Serves as individual contributor, providing the full spectrum of
responsibilities outline for the Sr. ESR/Sr. Medicaid Coordinator
including but not limited to:
* Assists with managing of ACD lines
* Assists with hiring and orientation of new staff
* Supervise daily activities within the unit which includes:
* monitoring of work volume for staff person,
* reassigning work assignments based on the needs
* Monitors enrollment process to ensure the quality standards are
* Conducts Call Quality
* Reports and analyzes enrollment and call data
* Provides assistance to the rest of the team, including Medicaid
Coordinators and ESRs, regarding job related tasks and acts as a go
* Provide assistance with ad-hoc projects assigned by the
Education, Licenses, certification and experience requirements:
Education: Bachelor s Degree in business, health administration,
public health, nursing or related health preferred or
License: None required
Certification: None Required
Experience: 3 to 5 years in a management role within a health care
setting managing front line call staff. Must have knowledge of
regulatory requirements for the health care/appeal industry,
excellent written and oral communication skills, excellent
organizational and analytical skills, customer service focused,
problem-solving ability, and conflict resolution skills.
* Customer focus
* Commitment Through Action
* Contributes to Team Performance
* Focus Upon Quality
* Flexible and Adaptive
Fallon Health is an equal opportunity employer. It is very
important for us to maintain a consistant hiring process for every
candidate. In addition, we are also a government contractor with
requirements to report on our Affirmative Action planning. To that
end, we require everyone to apply online.
If you do not have access to a computer or need assistance
completing the application process, please contact Human Resources
at 1-508-368-9893 (TRS 711).
Keywords: Fallon Health, Worcester , Senior Care Enrollment and Eligibility Lead, Other , Worcester, Massachusetts
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