EEMS Escalation Supervisor I (LTC) (Eligibility Coordinator I) / 60015792RP

State of South Carolina; Columbia (SC); On-site; USD 70,000 - 90,000; Full time

Job summary

State of South Carolina is seeking an EEMS Escalation Supervisor I (LTC) to lead the LTCW Escalation Specialists and drive timely, accurate eligibility determinations while ensuring high customer service standards. This in-office role requires supervisory experience and deep Medicaid knowledge.

The position operates within the Specialty Unit, Statewide, and involves cross-team collaboration, training, and data-driven process improvements to achieve department goals.

Qualifications

• High school diploma and relevant experience in customer services, social services, and Medicaid processing.
• Two years of supervisory experience preferred.
• Extensive knowledge of Medicaid programs and eligibility.

Responsibilities

• Lead a team of Medicaid Eligibility Specialists and manage daily workflow.
• Provide coaching, performance counseling, and training.
• Ensure timely and accurate eligibility determinations.
• Collaborate with related departments to improve customer service.
• Back up point of contact for the Program Coordinator II and escalations.

Skills

Supervisory experience

Medicaid knowledge

Customer service

Team leadership

Data analysis

Communication

EEOC compliance

Education

High school diploma

Bachelor's degree substitution

Job description

*This position is a repost. Previous applicants do not need to reapply.*

The Agency's mission is to be boldly innovative in improving the health and quality of life for South Carolinians.

This position is located in Specialty Unit, Statewide.

This is an in-office role and not a telecommute or remote position.

Are you the One?

We are looking for an EEMS Escalation Supervisor I (LTC), who will serve as Supervisor and is responsible for the leadership and direction of the Tier One Escalation LTCW Escalation Specialists. Responsible for timely and accurate eligibility determinations and positive customer service. Is directly responsible for ensuring team members are held accountable for timely and accurate determinations. Serves as the back up point of contact for the EEMS Escalations Supervisor (LTC).

• Leads a team of skilled Medicaid Eligibility Specialists, directing the efforts of Specialists and managing work within the team. Monitors team member performance on a day-to-day basis. Implements agency-standard workflow processes and procedures. Provides guidance to team members and agency managers on the effectiveness of agency policies, procedures, and processes. Ensures Specialists are held accountable to established guidelines for the performance of workplace duties.
• Receives and interprets employee performance reports and provides accurate counseling to Eligibility Specialists in a timely manner. Performs correct administrative follow-up activities after employee counseling and consults human resources when needed to complete employee evaluation or disciplinary action. Reviews and assist with identifying staff needs, workforce development opportunities and forecasting training opportunities for staff within the LTC Escalation Team. Identifies high-performing employees as candidates for reward or promotion. Provides positive reinforcement and messaging to employees about departmental goals and standards. Leads a team that meets, in the aggregate, Medicaid Eligibility Specialist performance standards.
• Provides technical assistance to Medicaid Eligibility Specialists and aids in the resolution of common questions, concerns, and escalations received by Medicaid Eligibility Specialists. Accurately addresses or routes questions and escalations to the appropriate resource including team leads, training staff, or help desk professionals, among others. Periodically spot-checks worker performance with respect to attendance, productivity, completeness of application workbooks, and accuracy of determinations.
• Performs fundamental supervisory and leadership functions in accordance with Department policies and procedures, best practices and Federal and State rules and regulations, especially with regard to Equal Employment Opportunity Commission (EEOC) standards. Maintains an effective organizational team and motivates staff to accomplish mission critical operations and objectives. Promotes workforce engagement and a safe, professional, and productive work environment for all employees.
• Attends meetings and training sessions as required. Makes and keeps schedules, completes tasks timely and reports to work timely. Assists eligibility management and senior leadership with projects as assigned. Performs related duties as assigned or required. Ensures Eligibility Specialists attend and successfully complete all training. Performs and coordinates preparedness/shelter duty activities as assigned.
• Serves as the back up point of contact for the Program Coordinator II, EEMS Escalations Supervisor (LTC). Works closely with Member Services, Bureau of Managed Care Organization, and Appeals to address opportunities for enhancing customer service. Ensures accurate eligibility determinations and strives to improve stakeholder experience and outcomes. As needed, provides data driven recommendations to leadership of trends and findings, address federal standards of promptness guidance, and strives to increase efficiency and productivity. Collaborate and streamlines with stakeholders and state agencies to ensure all expectations are met.

The South Carolina Department of Health and Human Services offers an exceptional benefits package for FTE and TGE positions that includes:

• Health, Dental, Vision, Long Term Disability, and Life Insurance for Employee, Spouse, and Children.
• 15 days annual (vacation) leave per year.
• 15 days sick leave per year.
• 13 paid holidays.
• State Retirement Plan and Deferred Compensation Programs.

A high school diploma and relevant experience in customer services, social services, human services, and/or Medicaid processing.

A bachelor’s degree may be substituted for the required program experience.

Preferred

At least two (2) years of supervisory experience.

Additional Requirements:

• Requires holder to drive routinely.
• Occasional overnight travel
• Overtime and/or weekend work with Deputy approval.
• Sitting or standing for long periods of time.
• Lifting requirements: 20 lbs.
• Valid driver’s license
• Requires Emergency Preparedness/shelter duties
• In-office Role

• Extensive knowledge of the Medicaid Program, human services programs, or eligibility processing preferred.
• Supervisory and management experience preferred. Knowledge of laws, regulations, policies and procedures relevant to Medicaid eligibility.
• Ability to exercise judgment and discretion.
• Ability to establish and maintain effective working relationships.
• Ability to effectively manage time and prioritize tasks and projects with competing deadlines.
• Demonstrated ability to lead and manage a diverse staff.
• Ability to communicate and collaborate with staff from different levels of the workforce.

The South Carolina Department of Health and Human Services is committed to providing equal employment opportunities to all applicants and does not discriminate on the basis of race, color, religion, sex (including pregnancy, childbirth or related medical conditions, including, but not limited, to lactation), national origin, age (40 or older), disability or genetic information.