Enrollment/Eligibility Manager

Description & Requirements

Maximus is looking for an Eligibility Manager to supports our FED State East project.

This position is responsible for managing the overall eligibility application processing.

This position must be able to use a range of measurements to forecast, monitor, analyze, plan, and manage resources to achieve contractual service level agreements, while maintaining a high level of customer service.

The Enrollment & Eligibility Manager will be responsible for the daily operations of Enrollment & Eligibility Staff.

Essential Duties and Responsibilities:

- Stay updated on Enrollment and Eligibility performance standards, corporate, and project policies.

- Assist and inform staff about these policies and procedures.

- Provide guidance when handling escalated complaints and appeals.

- Identify and resolve employee issues, problems, and concerns.

- Address quality concerns with the Supervisory team regarding application and appeal reviews and corrections.

- Analyze weekly statistics, prepare daily and weekly reports.

- Monitor performance objectives for Enrollment and Eligibility Staff.

- Coach teams, set expectations, conduct performance evaluations, and support career development for assigned staff.

- Assess performance, provide appraisals, and implement corrective actions as needed.

- Evaluate training needs to ensure staff remains current with multiple programs.

- Keep leadership informed on quality, training, policies, procedures, staff issues, and departmental performance.

Minimum Requirements

Minimum Requirements:
- Bachelor's degree in relevant field of study and 5+ years of relevant professional experience required, or equivalent combination of education and experience.

Additional Requirements:

- Working knowledge of Medical and Insurance Terminology.

- Experience reading EOB/Provider remittance.

- Critical thinking and strategic decision making.

- Attention to detail

Remote Position Requirements:

- Noise free Private and Secure workspace from home

- Wired internet connection with minimum download speed of 25 mbps and minimum upload speed of 10mbps (No Hotspots or Wifi)

- Wired USB headset

EEO Statement

Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.

We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country.

We're proud of our connections to organizations dedicated to serving veterans and their families.

If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you.

A committed and diverse workforce is our most important resource.

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