Eligibility Policy Manager - 00203660

Pay Grade: N

The Georgia Department of Community Health (DCH) is one of Georgia's four health agencies serving the state's growing population of over 10 million people. DCH serves as the lead agency for Medicaid, oversees the State Health Benefit Plan (SHBP) and Healthcare Facility Regulation, impacting one in four Georgians.

 

Through effective planning, purchasing and oversight, DCH provides access to affordable, quality health care to millions of Georgians, including some of the state's most vulnerable and under-served populations. Six enterprise offices support the work of the agency’s three program divisions. DCH employees are based in Atlanta, Cordele and across the state. 

 

DCH is committed to providing superior Customer Service and Communication, embracing Teamwork and fostering Accountability to ensure that our internal and external customers and stakeholders feel included, respected, engaged and secure.  

The Department of Community Health is seeking qualified candidates for the Eligibility Policy Manager in the Medical Assistance Plans Division.  This is a hybrid position that requires in-office and remote work with the approval of the supervisor.  The days and frequency in the office can change at any time during employment based on the business needs of the organization.

 

 The Eligibility Policy Manager is responsible for reviewing and administering legal guidelines for Medicaid eligibility.
Roles and responsibilities:
• Conducts eligibility processing audits
• Provides assistance in understanding eligibility policies
• Sends memos to appropriate stakeholders regarding policy changes as required
• Interpretation, dissemination, and implementation of federal and state policy related to eligibility
• Updates eligibility section of state plan
• Work on DCH policy updates with CMS as required
• Update eligibility policies as required to Medicaid State Plan
• Develop training materials, forms, and conduct training/monitoring when policy requires a new program (i.e. Hospital Presumptive Eligibility)
• Initiate changes, review design, and participate in testing for the State’s integrated eligibility system (Gateway)Bachelor's degree in a related field from an accredited college or university AND Four years of experience managing professional level staff OR Eight years of related professional experience AND Four years managing at the level equivalent to area of assignment OR Four years of experience required at the lower level Mgr 2, Business Ops (GSM011) or position equivalent. Note: An equivalent combination of education and job specific experience that provided the knowledge, experience and competencies required to successfully perform the job at the level listed may be substituted on a year-over-year basis.

Preferred Qualifications:

• Strong background in Healthcare, Public Administration, or other health-related field
• Significant experience with Medicaid, CMS policies and regulations
• Strong knowledge of Medicaid eligibility policies
• Ability to research and understand how federal regulations apply to DCH MAP
• Strong knowledge and understanding of DFCS policies and procedures

EARN MORE THAN A SALARY! In addition to a competitive salary, the Georgia Department of Community Health offers a generous benefits package, which includes employee retirement plan; paid holidays annually; vacation and sick leave; health, dental, vision, legal, disability, accidental death and dismemberment, health and child care spending account.

 

Due to the volume of applications received, we are unable to provide information on application status by phone or e-mail. All qualified applicants will be considered, but may not necessarily receive an interview. Selected applicants will be contacted by the hiring agency for next steps in the selection process. Applicants who are not selected will not receive notification. 

 

THIS POSITION IS SUBJECT TO CLOSE AT ANY TIME ONCE A SATISFACTORY APPLICANT POOL HAS BEEN IDENTIFIED. APPLICATIONS WITHOUT WORK EXPERIENCE LISTED WILL NOT BE CONSIDERED. CURRENT GEORGIA STATE GOVERNMENT EMPLOYEES WILL BE SUBJECT TO STATE PERSONNEL BOARD (SPB) RULE PROVISIONS. THE POSITION MAY BE FILLED AT A LOWER OR HIGHER POSITION LEVEL.

 

This position is unclassified and employment is at-will. Candidates for this position are subject to a background history and reference check. For more information about this job contact: : http://dch.ga.gov