Supervisor, Eligibility & Screening (Bayfield, WI, Douglas, WI, Ashland, WI, Iron, WI, Sawyer, WI...

Job Description

JOB DESCRIPTION Job SummaryLeads and supervises team supporting long-term care eligibility, screening processes and coordination for older adults and adults with physical or intellectual disabilities. Contributes to overarching strategy to provide quality and cost-effective care. \n
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\nEssential Job Duties \n
\n • Hires, trains, develops and supervises eligibility screeners; responsible for hiring and training new eligibility screeners, check-ins with team members, feedback and coaching, and ongoing compliance and quality of eligibility screener work. \n
\n • Assists in problem-solving and decision-making related to screens, member related issues, adverse eligibility findings, timing of screens, coordination of screens with moves and discharges, and other screening issues that arise. \n
\n • Attends meetings and represents as subject matter expert and consultant to key stakeholders in regards to the long-term care functional screen (LTCFS) program, and attends and facilitate fair hearings related to functional ineligibility. \n
\n • Completes the adult LTCFS as required and outlined in applicable regulatory guidelines; this includes completing collateral contacts to verify screen findings with internal and external stakeholders, and verifying diagnosis information with physicians and/or the Social Security Administration (SSA). \n
\n • Complies with documentation and LTCFS program regulations, guidelines and meets screening quota. \n
\n • Participates in and assists with screener meetings, quizzes and testing. \n
\n • Collaborates on development, process improvement and ongoing quality management of services of related LTCFS materials/products. \n
\n • Provides data reports related to the LTCFS as requested. \n
\n • Maintains long-term functional screening LTCFS certification by completing and passing continuing skills testing (CST). \n
\n • Local travel may be required (based upon state/contractual requirements). \n
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\nRequired Qualifications \n
\n • At least 5 years of experience in health care, and at least 3 years experience managed long-term care and/or human services serving one of the target groups (adults with physical/intellectual disabilities or older adults), or equivalent combination of relevant education and experience., or equivalent combination of relevant education and experience. \n
\n • Current long-term functional screening (LTCFS) certification. \n
\n • Registered Nurse (RN) may be required for certain states (dependent upon state/contractual requirements). If licensed, license must be active and unrestricted. \n
\n • Demonstrated understanding of electronic medical records and Health Insurance Portability and Accountability Act (HIPAA). \n
\n • Strong organizational and time-management skills. \n
\n • Ability to write routine reports, correspondence, and speak effectively with internal and external stakeholders. \n
\n • Ability to regularly make decisions related to how a project or operation will be conducted. \n
\n • Ability to read, analyze, and interpret business manuals, technical procedures, and government regulations. \n
\n • Excellent verbal and written communication skills. \n
\n • Microsoft Office suite/applicable software program(s) proficiency. \n
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\nPreferred Qualifications \n
\n • Supervisory/leadership experience. \n
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\n To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. \n
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\n Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $49,930 - $97,363 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.