Eligibility Screener and Operations Support - Remote USA (MST time zone preferred) at Magellan Health Services inc in Washington, Washington DC

Job Description:

*MST time zone preferred

This position works directly with members and non-members to ensure that they have access to assistance in completing eligibility and redetermination screenings in a timely manner. The role includes conducting eligibility screenings that determine eligibility for other state funding and GPRA assessments. This position will also support operations with other administrative functions that could support departments such as clinical operations, network, compliance, and quality.

• Manage the daily task lists in TruCare for eligibility screenings that need to be completed.


• Perform eligibility screenings to determine member eligibility for various state funding programs and administer Government Performance and Results Act (GPRA) assessments.


• Help facilitate appropriate referrals for members who no longer meet state eligibility requirements or other applicable programs.


• Manage lists generated from the Enrollment department to identify members at risk of losing coverage and provide outreach.


• Follow up on alerts regarding member eligibility issues, offering support and outreach to members and their families.


• Document all actions, including phone calls and member interactions, in the centralized record system in a timely manner.


• Make recommendations for policy and procedure improvements focused on member retention, workflow efficiencies, and member satisfaction.


• Submit help desks tickets for issues that may be needed due to requirements of the screening or when there are issues with the medical record system.


• Perform administrative functions, including phone calls, emails, or other communications that help support the operations of the organization.


• Demonstrate ability to meet performance metrics, including volume-based targets for calls, eligibility screenings, and surveys.


• Assist with managing Authorization to Use and Disclose (AUD) process.

Responsibilities
2+ years of relevant experience in the human services field required.
Proven ability to build relationships and collaborate with providers and members.
High level of accountability and responsibility for outcomes.
Excellent interpersonal, verbal, and written communication skills.
Strong problem-solving skills and creativity.
Proficiency with Microsoft Office products and ability to quickly learn new software applications.

General Job Information

Title
Eligibility Screener and Operations Support - Remote USA (MST time zone preferred)

Grade
18

Work Experience - Required
Behavioral Health, Healthcare

Work Experience - Preferred

Education - Required
GED, High School

Education - Preferred
Bachelor's

License and Certifications - Required

License and Certifications - Preferred

Salary Range

Salary Minimum:
$34,295
Salary Maximum:
$51,445

This 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.