Human Srvs Prog Branch Manager

Commonwealth of Kentucky; Frankfort (KY); Hybrid; USD 78,000 - 88,000; Full time

Job summary

The Commonwealth of Kentucky, Cabinet for Health and Family Services, Department for Medicaid Services, in Frankfort, seeks an experienced Human Services Program Branch Manager to lead the Appeals and Complaints Branch. Hybrid telecommuting may be approved; onsite presence is required three days weekly.

The role requires a bachelor’s degree and at least five years of relevant experience in human services administration, with strong supervisory and regulatory compliance skills.

Qualifications

• Knowledge of Medicaid programs, eligibility and managed care requirements.
• Understanding of federal and state laws governing appeals, complaints and hearings.
• Experience in supervision, training, and performance management.

Responsibilities

• Provide leadership and Oversight for the Appeals and Complaints Branch.
• Coordinate External Independent Third-Party Review (EITPR) and administrative hearings.
• Ensure timely processing of appeals and hearing-related matters within federal/state timeframes.
• Supervise and develop branch staff, promoting collaboration and accountability.
• Monitor workload, performance, case status, and deadlines for timely resolutions.
• Review complex cases and provide guidance to staff.
• Coordinate with internal divisions, legal, program staff, health plans and providers.
• Identify recurring issues and recommend process improvements.
• Ensure branch operations comply with laws, regulations and Medicaid requirements.
• Develop procedures for consistency, efficiency, quality and documentation.
• Prepare and review reports and correspondence related to EITPRs and hearings.
• Represent the branch in meetings and communicate needs to leadership.
• Support training and quality assurance activities.

Skills

Medicaid program knowledge

Regulatory compliance

Case management principles

Staff supervision

Performance monitoring

Stakeholder communication

Process improvement

Education

Bachelor's degree

Job description

Human Srvs Prog Branch Manager

Advertisement Closes: 10/29/2026 (11:59 PM ET)

Pay Grade: 17

Salary: $77,637.84 - $87,990.00 Annually

Employment Type: EXECUTIVE BRANCH | FULL TIME | INELIGIBLE FOR OVERTIME PAY | 18A | 37.5 HR/WK

Hiring Agency: Cabinet for Health & Family Services | Department for Medicaid Services

Location: 275 East Main Street
Frankfort, KY 40621 USA

The agency may authorize the selected candidate to telecommute as a Hybrid. The agency may terminate or modify the telecommuting arrangements at any time. This position is located in Frankfort, KY and is required to come to the office three days per week.

Description

The Department for Medicaid Services (DMS) provides health care access for eligible low-income residents of Kentucky including children, families, pregnant women, the aged and the disabled as well as a number of programs and services directed at specific eligibility and medical needs. DMS strives each day to meet the mission of the Cabinet for Health and Family Services to be a diverse and inclusive organization providing programs, services, and supports that protect and promote the health and well-being of all Kentuckians and their communities.

Do you thrive in a fast-paced work environment? Do you enjoy working collaboratively with a dedicated team? If you answered yes to both questions, we may have an opportunity for you! The Department for Medicaid Services, Division of Health Plan Oversight, is seeking a qualified and motivated professional to serve as the Appeals and Complaints Branch Manager.

In this role, the Human Services Program Branch Manager will provide leadership and oversight for the Appeals and Complaints Branch, including the management and coordination of External Independent Third-Party Review (EITPR) and administrative and state fair hearings. The position will be responsible for ensuring that appeals, and hearing-related activities are managed effectively, timely, consistently, and in accordance with applicable federal and state requirements, Medicaid policies, and agency procedures.

Learn more about us at: https://chfs.ky.gov/agencies/dms/Pages/default.aspx

Responsibilities and Duties

• Provide leadership, direction, and oversight for the Appeals and Complaints Branch.
• Manage and coordinate EITPRs and administrative hearing activities.
• Ensure EITPR’s and hearing-related matters are processed accurately and within established federal and state timeframes.
• Supervise, coach, and develop branch staff while promoting a collaborative and accountable workenvironment.
• Monitor workload, performance measures, case status, and deadlines to ensure timely resolution of matters.
• Review complex or sensitive cases and provide guidance and direction to staff.
• Coordinate with internal DMS divisions, legal representatives, program staff, health plans, providers, beneficiaries, and other stakeholders as appropriate.
• Identify recurring issues and trends and make recommendations for process improvements.
• Ensure branch operations comply with applicable laws, regulations, Medicaid requirements, policies, and procedures.
• Develop and implement procedures that promote consistency, efficiency, quality, and appropriate documentation.
• Prepare and review reports, correspondence, and other materials related to EITPRs, and administrative hearings.
• Represent the branch in meetings and workgroups and communicate program requirements and operational needs to leadership.
• Support the development and implementation of training and quality assurance activities.
• Perform other duties as assigned.

Skills and Expectations

• Medicaid programs, policies, eligibility requirements, and managed care operations.
• Federal and state laws, regulations, and requirements governing Medicaid appeals, complaints, and administrative hearings.
• Principles and practices of case management, quality assurance, and regulatory compliance.
• Kentucky Medicaid programs and the health care delivery system.
• State and federal requirements related to beneficiary rights and access to health care services.
• Data collection, analysis, reporting, and performance monitoring.
• Supervisory and management principles, including staff development, workload management, performance management, and team building.
• Conflict resolution, problem-solving, and effective communication with internal and external stakeholders.
• Process improvement principles and methods for improving efficiency, consistency, and quality.
• Records management, confidentiality, and appropriate handling of sensitive information.

The Cabinet for Health and Family Services (CHFS) participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in U.S. CHFS will only use E-Verify once you have accepted a job offer and completed the Form I-9. For more information on E-Verify, or if you believe that CHFS has violated its E-Verify responsibilities, please contact Department of Homeland Security (DHS) at 888-897-7781 or https://www.e-verify.gov/

Minimum Requirements

EDUCATION: Graduate of a college or university with a bachelor's degree.

EXPERIENCE, TRAINING, OR SKILLS: Five years of professional experience in the administration of human services programs, emergency management services, emergency medical technician, paramedic, or related field.

Substitute EDUCATION for EXPERIENCE: A master's degree in social work, health administration, labor relations, public or business administration or related field will substitute for one year of the required experience.

Substitute EXPERIENCE for EDUCATION: Administrative or business experience, or professional, subprofessional, or clerical work in a human services area, emergency management services, emergency medical technician, paramedic, or related field will substitute for the required education on a year- for- year basis.

SPECIAL REQUIREMENTS (AGE, LICENSURE, REGULATION, ETC.): NONE

Working Conditions

Incumbents working in this job title typically perform duties in an office setting.

Probationary Period

This job has an initial and promotional probationary period of 6 months, except as provided in KRS 18A.111.

Contact

If you have questions about this advertisement, please contact Whitley Walker at Whitley.Walker @ky.gov or 502-564-8890.

Equal Opportunity Employer

An Equal Opportunity Employer M/F/D