Single point of contact for all eligibility issues. This position oversees the processes in place for eligibility and referral requirements as defined within the agency contract. This position serves as a liaison for providers, various state agencies and interdepartmental business leads.
Uses independent decision making and experience to investigate and resolve eligibility complaints and general inquiries.
Responsible for interfacing with internal and external customers for complex eligibility issue.
Participates in conference calls and meetings as needed.
Owns the eligibility mailbox which includes provider eligibility complaints and issues and provides timely responses to all inquiries.
Maintains a barrier resolution process within and between the system partners to translate system successes and barriers into positive systematic changes.
Partners with Medicaid, state agencies and/or IT to correct the appropriate eligibility system.
Collaborates with providers and various State agencies to streamline processes and procedures in an effort to achieve a seamless system among all participating agencies/organizations.
Facilitates inter-agency site meetings in which system issues are presented.
Recommends practice adjustments, policy and procedure revisions, training and support in an effort to provide continuous improvement.
Provides timely feedback to management regarding any barriers to care center operations.
Other Job Requirements
ResponsibilitiesMinimum 3+ years of experience working with eligibility and referral processes.Experience coordinating and facilitating inter-agency meetings.Proficient in MS Office software.General Job Information TitleEligibility LiaisonGrade21Work Experience - Required Customer ServiceWork Experience - Preferred Education - Required A Combination of Education and Work Experience May Be Considered., Bachelor'sEducation - Preferred License and Certifications - Required License and Certifications - Preferred Salary RangeSalary Minimum:$45,655Salary Maximum:$68,485This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
