Economic Services Supervisor-Family Medicaid

McDowell County•Department of Social Services, NC

1d•Onsite

About The Position

Performs advanced professional, administrative, and supervisory work directing the daily operations of the Family Medicaid unit within the Department of Social Services. The employee supervises Economic Services Caseworkers and support staff responsible for determining eligibility for Family Medicaid and related Medicaid programs in accordance with federal and state regulations. Responsibilities include planning, organizing, assigning, reviewing, and evaluating staff performance while ensuring compliance with all applicable North Carolina Department of Health and Human Services (NCDHHS), Division of Health Benefits (DHB), county, and program policies. The supervisor monitors productivity, accuracy, timeliness standards, quality assurance, customer service, and program integrity while promoting efficient and accessible service delivery to McDowell County residents.

Requirements

Comprehensive knowledge of Federal and State Medicaid laws, regulations, policies, and procedures.
Comprehensive knowledge of North Carolina Economic Services policies and procedures.
Comprehensive knowledge of NC FAST eligibility and case management systems.
Comprehensive knowledge of Medicaid eligibility requirements and income maintenance principles.
Comprehensive knowledge of Family Medicaid programs and related public assistance programs.
Comprehensive knowledge of Supervisory principles and employee performance management.
Comprehensive knowledge of Quality assurance and program integrity standards.
Comprehensive knowledge of Public assistance program administration.
Comprehensive knowledge of State and federal confidentiality and privacy requirements.
Comprehensive knowledge of Principles and practices of effective customer service.
Ability to interpret and apply complex federal and state Medicaid regulations and policies.
Ability to supervise, train, coach, and motivate employees.
Ability to analyze complex eligibility situations and make sound decisions.
Ability to review case records for accuracy, completeness, and compliance.
Ability to monitor performance data and identify areas requiring improvement.
Ability to prepare reports and maintain accurate records.
Ability to communicate effectively both orally and in writing.
Ability to build positive working relationships with staff, clients, healthcare providers, and community partners.
Ability to handle stressful, sensitive, and high-volume situations with professionalism.
Ability to exercise sound judgment and independent decision-making.
Ability to adapt to frequent changes in Medicaid policy, procedures, and technology.
Valid North Carolina Driver's License.
Ability to travel for required training, meetings, conferences, and other official county or state business.
Successful completion of required state and county training.
Background investigation as required for county employment.

Nice To Haves

North Carolina Income Maintenance Caseworker certification.
Supervisory experience within a county Department of Social Services.
Extensive experience using NC FAST.
Experience with Family Medicaid and related Medicaid programs.
Experience with Medicaid quality assurance and performance monitoring.
Knowledge of NCDHHS/DHB Medicaid policies and performance standards.
Experience conducting staff training and providing technical assistance.
Experience handling complex Medicaid eligibility cases and escalated client concerns.

Responsibilities

Supervises Economic Services Caseworkers, Processing Assistants, and other assigned personnel.
Assigns, prioritizes, and monitors workloads to ensure timely processing of Medicaid applications, recertifications, changes, and other case actions.
Conducts performance evaluations and provides coaching, mentoring, and corrective action when appropriate.
Assists with recruitment, interviewing, onboarding, and training of new employees.
Develops work schedules and approves leave requests.
Conducts staff meetings and communicates program updates, policy changes, and operational expectations.
Provides guidance and technical assistance to staff regarding complex eligibility issues.
Promotes consistent application of Medicaid policies and procedures among assigned staff.
Oversees the administration of Family Medicaid and related Medicaid programs assigned to the unit.
Ensures compliance with federal and state Medicaid regulations, NCDHHS/DHB policies, and county procedures.
Reviews complex eligibility determinations and resolves difficult or unusual cases.
Monitors application processing, recertification, change reporting, and other required case actions to ensure compliance with established timeliness standards.
Ensures accurate and complete documentation within NC FAST.
Assists staff with interpretation and implementation of changing Medicaid policies, procedures, and eligibility requirements.
Coordinates implementation of new policies, procedures, system changes, and program initiatives.
Monitors workload and staffing levels and makes recommendations regarding resource allocation.
Performs quality control and supervisory reviews of case records.
Identifies trends in errors, deficiencies, or processing issues and develops corrective action plans.
Monitors state performance reports, accuracy measures, timeliness standards, and county performance indicators.
Responds to quality assurance findings and develops strategies for improvement.
Ensures appropriate documentation and case maintenance practices.
Ensures confidentiality and security of protected health, financial, and client information.
Assists with state monitoring visits, reviews, audits, and corrective action activities.
Promotes program integrity and compliance with Medicaid eligibility requirements.
Handles escalated client concerns and complaints.
Provides guidance to staff regarding difficult or sensitive client situations.
Serves as a liaison with healthcare providers, community agencies, advocacy organizations, and other partner agencies as appropriate.
Provides information regarding Medicaid eligibility policies and procedures within the scope of the position.
Promotes professional, respectful, and timely customer service standards throughout the unit.
Assists in resolving barriers that may prevent eligible individuals and families from accessing Medicaid services.
Prepares reports, statistical data, and other information related to Family Medicaid operations.
Monitors staffing needs, workload distribution, productivity, and case processing performance.
Recommends policy and procedural improvements.
Assists with planning and implementation of program-related initiatives.
Participates in county committees, leadership meetings, state training sessions, and other meetings as assigned.
Maintains appropriate records and documentation related to unit operations.
Assists management with identifying training needs and developing staff development activities.