Eligibility Coordinator II / 60017888

State of South Carolina; Columbia (SC); On-site; USD 43,000 - 52,000; Full time

Benefits offered by this job

Health insurance

Dental insurance

Vision insurance

Long-term disability

Life insurance

Paid vacation 15 days

Sick leave 15 days

13 paid holidays

State retirement plan

Deferred compensation

Job summary

State of South Carolina is seeking an Eligibility Coordinator II to supervise up to 20 eligibility staff in the Midlands MEOC. This in-office role leads workflow, ensures timely Medicaid eligibility determinations, and supports service delivery with strong leadership and policy guidance.

The position emphasizes coaching, performance management, and adherence to EEOC standards while driving operational success in eligibility processing for SC residents.

Qualifications

• A bachelor’s degree and professional experience in human services or social services programs.
• Equivalent combination of education and experience may be considered with prior State HR approval.
• Preferred: At least two years in Medicaid and at least four years in management/leadership roles.

Responsibilities

• Lead a team of up to 20 eligibility staff and allocate work.
• Ensure timely and accurate eligibility determinations and high-quality customer service.
• Provide coaching, performance counseling, and guidance on policies and procedures.
• Coordinate with managers and staff to meet operational objectives and compliance.

Skills

Leadership & supervision

Medicaid eligibility

Staff coaching

Policy interpretation

EEOC compliance

Education

Bachelor's degree

Job description

• This position is a re-post. Previous applicants do not need to re-apply.*

Job Responsibilities

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

This is position is located in Eligibility, Enrollment and Member Service (EEMS) Processing Centers of the Midlands, Richland County.

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

Are you the One?

We are looking for an Eligibility Coordinator II who, under the direct supervision of the Program Manager for Processing Center operations, serves as Supervisor and is responsible for managing a team of up to 20 [Non-MAGI/MAGI/LTCW] eligibility staff. Provides leadership and direction to eligibility team staff. Responsible for timely and accurate eligibility decisions, delivery of services, and customer service. Supports the achievement of performance and operational success for eligibility determination processing.

• Leads a team of skilled Medicaid Eligibility specialists in a Medicaid Eligibility Operations Center (MEOC), directing the efforts of Specialists and allocating work within the team. Assigns Medicaid eligibility applications, reviews, and changes to team members and monitors team member performance on a day-to-day basis. Implements agency-standard workflow processes and procedures and provides guidance to team members and agency managers on the effectiveness of agency policies, procedures, and processes. Establishes clear and consistent guidelines for the performance or workplace duties.
• Implements Medicaid Eligibility Specialist performance standards in accordance with departmental policies and guidelines. Provides monthly, quarterly, annual, and as-needed written and verbal counseling to teammates to explain each team member’s performance relative to departmental standards. Assists team members with workplace action plans to ensure each team member can meet departmental standards for the timeliness and accuracy of eligibility determinations.
• 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 diverse 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. Program Manager for Statewide Long-Term Care Eligibility Operations with special projects. Performs related duties as assigned or required. Ensures staff attends and successfully completes all training. Performs and coordinates preparedness/shelter duty activities as assigned.

Benefits

• 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.

Minimum And Additional Requirements

A bachelor’s degree and professional experience in human services or social services programs.

An equivalent combination of education and experience may be considered with prior State Human Resources approval.

Preferred: At least two (2) years working in Medicaid related programs and at least four (4) years of experience in management and leadership roles, directly responsible for program outcomes and creating solutions for improved performance.

Additional Requirements

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

Preferred Qualifications

• Extensive knowledge of the Medicaid Program, human services program, or case processing preferred.
• Supervisory and Management experience preferred.
• Ability to analyze and interpret broad health and human service issues and their impact on the Department's programs.
• Knowledge of laws, regulations, policies and procedures relevant to the area of employment.
• 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 and/or shifting deadlines.
• Must be able to lead and manage a diverse staff.
• Ability to communicate and collaborate with staff from different levels of the workforce.
• This position is accountable for managing a unit responsible for customer service that have impact on both the financial well-being of the State and the availability of resources to provide healthcare to the State's needy citizens.
• Employee must be able to make frequent independent decisions, work independently, and use discretion with only limited supervision.

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.

Benefits For State Employees

The state of South Carolina offers eligible employees generous benefits, including health and dental insurance; retirement and savings plan options; and paid vacation and sick leave. Plus, work-life balance programs such as telecommuting and flexible work schedules are available to employees of some state agencies.

Insurance Benefits

Eligible employees may enroll in health insurance, which includes prescription coverage and wellness benefits. Other available insurance benefits include dental, vision, term life insurance, long term disability and flexible spending accounts for health and child care expenses.

Retirement Benefits

State employees are also offered retirement plan options, including defined benefit and defined contribution plans. Additionally, eligible employees may elect to participate in the South Carolina Deferred Compensation Program, which is a voluntary, supplemental retirement savings plan offering 401(k) and 457 plan options.

Workplace Benefits

State employees may also be eligible for other benefits, including tuition assistance; holiday, annual and sick leave; and discounts on purchases, travel and more.

Note

The benefits above are available to most state employees, with the exception of those in temporary positions. Employees in temporary grant and time-limited positions may be eligible for all, some or none of these benefits as benefits are associated with each position type. For these positions, contact the hiring agency to determine what benefits may be available.

Salary: $47,588.