Entitlement Manager

Briya Public Charter School•Washington, DC

5d•Hybrid

About The Position

The Entitlement Manager oversees BHAP, DC Health Link, Prince George’s County Health Connect, and Montgomery County programs. The role supports adherence to program requirements for DC and Maryland residents in Medicaid, Alliance, private insurance, and other entitlement programs, as well as Affordable Care Act programming. The Manager ensures compliance with protocols and best practices established by contractors, funders, and regulations. Reporting to the Director of Patient Administrative Services, the Manager trains qualified staff, monitors staff performance, supports project reporting, and assists with communication and advocacy on behalf of the programs and communities served. The role supervises three supervisors and manages three programs. It also provides insurance-screening coverage when needed, including screening participants for public benefits, assisting with applications, tracking application status, advocating with government offices, and resolving insurance issues with managed care organizations.

Requirements

Strong supervisory experience.
Experience working in a fast-paced setting and ability to operate independently.
Fluency in English/Spanish or English/Amharic.
Thorough understanding and working knowledge of patient confidentiality protocols and HIPAA compliance and regulations.
Ability to perform the physical demands of the role, including lifting objects up to 25 pounds.

Nice To Haves

Experience in a medical setting.
Experience working directly with clients.
Knowledge of public benefits programs and eligibility standards in the District and Maryland.

Responsibilities

Supervise staff who screen participants for insurance eligibility, meeting with staff at least biweekly to review performance, progress toward objectives, documentation, and concerns.
Ensure staffing coverage at Mary’s Center and other identified locations.
Support smooth operation of District, Prince George’s County, and Montgomery County safety-net insurance enrollment processes, including Medicaid, Alliance, and other entitlements.
Evaluate staff performance annually and as needed, provide necessary resources, and take corrective action when appropriate.
Work with the Director of Patient Administrative Services and VP of Operations to develop memoranda of understanding with partner agencies when needed.
Assemble documentation and data for reports and provide quantitative data and narrative reports to funders.
Attend necessary meetings and help schedule staff for outreach and enrollment events.
Monitor staff supply needs and help ensure staff have necessary materials.
Strengthen partnerships with community resources in DC, Prince George’s County, and Montgomery County.
Screen participants for public benefits, counsel them about potentially available benefits, and assist with medical assistance applications when necessary.
Track pending applications, advocate for participants with government offices, and identify matters for referral to social services.
Build and maintain working relationships with public-benefit and community-based agencies in the District and Maryland, including DHS, PG County Social Services Department, DC Health Link, and Montgomery County.
Work with MCO representatives to resolve participant insurance issues, including changing plans or assigning a PCP.
Provide and model outstanding customer service to participants and the public.

Benefits

Medical, dental, and vision health insurance.
Retirement options through 403(b) contribution and investment opportunities.
25 days of paid leave annually, in addition to paid holidays.
Five educational days.
Tuition reimbursement of $2,000 per year toward education assistance and professional development, prorated based on regularly scheduled hours worked per week.
Transportation subsidy via metro and bus.
Employee Assistance Program (EAP).

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