Eligibility Supervisor

We are looking for an experienced Eligibility Supervisor to join our team in Port St. Lucie, Florida. In this role, you will oversee eligibility processes, ensuring compliance with federal and state regulations, while managing a team of specialists. This position requires excellent organizational skills, a strong understanding of Medicaid eligibility, and the ability to provide effective leadership in a dynamic environment.

Responsibilities:

• Oversee the collection and review of necessary case documentation such as court orders, birth certificates, and income verification to determine initial and ongoing eligibility for federal funding.

• Manage the submission and tracking of Medicaid and Title IV-E applications for children in out-of-home care, ensuring proper activation and compliance.

• Approve and review Title IV-E Federal Monitoring Tools and ensure the accuracy of eligibility determinations.

• Facilitate Medicaid applications for children who have achieved permanency through adoption.

• Provide Letters of Assurance to case managers and protective investigators to address immediate medical needs of children.

• Enroll eligible children into specialized healthcare and dental plans, including those with special needs.

• Address and resolve outstanding medical bills with providers, submitting payment requests when appropriate.

• Monitor eligibility determinations and update client information in the system as necessary.

• Collaborate with case managers and investigators to gather household and financial details for accurate eligibility assessments.

• Manage and guide a team of Eligibility Specialists, monitoring their performance and ensuring timely completion of responsibilities.

• Proven experience in Medicaid eligibility processes and administrative management.
• Strong understanding of Title IV-E and federal funding eligibility requirements.
• Ability to lead and manage a team effectively, ensuring high performance and compliance with procedures.
• Proficiency in using case management systems and maintaining accurate records.
• Excellent organizational and communication skills to collaborate with various teams and resolve issues.
• Experience with medical billing and resolving outstanding claims.
• Ability to analyze and interpret financial and household data for eligibility determination.
• Familiarity with federal monitoring plans and reporting requirements.