Entitlement Manager

Mary's Center • Washington, DC

5d • Hybrid

About The Position

The Entitlement Manager oversees the BHAP, DC Health Link, Prince George’s County Health Connect, and Montgomery County programs. The role supports compliance with program requirements for DC and Maryland residents participating in Medicaid, Alliance, private insurance, and other entitlement programs, as well as Affordable Care Act programming. The Manager ensures adherence to protocols and best practices established by contractors, funders, and regulations; trains and monitors staff; supports program reporting; and contributes to communication and advocacy efforts for the programs and communities served.

Reporting to the Director of Patient Administrative Services, the Manager supervises three supervisors across three programs. The position supports insurance enrollment operations across the District, Prince George’s County, and Montgomery County, including staff coverage, performance management, outreach and enrollment events, partnerships, documentation, and funder reports. When needed, the Manager also provides insurance screening and application assistance to participants and works with government offices, community agencies, and managed care organization representatives to address insurance needs.

Requirements

• Strong supervisory experience.
• Experience working in a fast-paced setting and ability to operate independently.
• Fluency in English and Spanish, or English and Amharic.
• Thorough understanding and working knowledge of patient confidentiality protocols and HIPAA compliance and regulations.
• Ability to perform the essential functions of the role, with reasonable accommodations available as needed.

Nice To Haves

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

Responsibilities

• Supervise staff who screen participants for insurance eligibility and meet with staff at least biweekly to review performance, objectives, documentation, and concerns.
• Ensure staff coverage at Mary’s Center and other identified locations.
• Support the operation of safety-net insurance enrollment processes in the District, Prince George’s County, and Montgomery County, including Medicaid, Alliance, and other entitlements.
• Evaluate staff performance annually and as needed, provide necessary resources, and implement corrective actions when appropriate.
• Work with the Director of Patient Administrative Services and VP of Operations to develop memoranda of understanding with partner agencies when needed.
• Compile documentation and data, and provide quantitative and narrative reports to funders.
• Attend necessary meetings and help schedule staff for outreach and enrollment events.
• Monitor staff supply needs and ensure staff have items necessary for their roles.
• Strengthen partnerships with community resources in DC, Prince George’s County, and Montgomery County.
• When needed, screen participants for public benefits, explain benefits for which they may be eligible, and help complete medical assistance applications.
• 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 agencies, 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 insurance.
• Retirement options through 403(b) contributions 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 weekly hours.
• Transportation subsidy via Metro and bus.
• Employee Assistance Program (EAP).

What This Job Offers

• Job Type: Full-time
• Career Level: Manager
• Education Level: No Education Listed