Become a part of our caring community and help us put health first
 

Join the Inclusa/Humana team in this exciting leadership role. The Eligibility Supervisor is primarily responsible for the day-to-day successful operation of the Financial Eligibility area. This includes effective and timely management and assignment of tasks, collaboration with others in the organization and supporting the work and needs of the financial eligibility team. providing daily leadership, management, and mentoring to staff, promoting objective, critical thinking with expertise surrounding enrollment, disenrollment and ongoing Medicaid and Family Care eligibility requirements. The Eligibility Supervisor provides direction, supervision, coaching, and performance improvement to staff to ensure that the organization supports members in maintaining financial eligibility for publicly funded long term care supports. This position serves as a liaison to external stakeholders, specifically Aging and Disability Resource Centers and Income Maintenance Consortiums in the coordination of the enrollment and disenrollment of individuals eligible for Family Care.

Leads a highly effective financial eligibility team through mentoring, coaching, unit collaboration and performance management.

• Ensures the team has the resources, technology, and access to information needed to complete their duties.
• Monitors and analyzes workload and implements efficiencies.
• Meets individually with team members on a regular basis and provides 1:1 mentoring through performance management.
• Develops and leads unit meetings to facilitate learning, promotes discussion to solicit feedback, team building, and positive work culture. Provides process and policy clarification and organizational communication.

Manages the process for maintaining member financial eligibility and ensures timely and accurate completion of Medicaid applications and renewals.

• Manages member eligibility for Medicaid through monitoring of recertification and enrollment reports, assigns and tracks status of member’s eligibility, and provides follow up communication and clarification as needed.
• Troubleshoots and problem solves to overcome barriers in maintaining Medicaid eligibility and research options, resources and processes to ensure eligibility is maintained if criteria is met.
• Oversees and tracks data related to member eligibility and provides recommendations for process improvement.
• Collaborates with external partners, Aging and Disability Resource Centers and Income Maintenance to resolve member specific eligibility issues.
• Collaborates regarding allegations of Medicaid fraud.

Provides leadership to the financial eligibility team that supports organizational goals and drives innovation.

• Collaborates with other departments, such as IT and Analytics on resource development to enhance strategic planning.
• Participates in workgroups and meetings with community partners such as Aging and Disability Resource Centers and Income Maintenance Consortiums.

Use your skills to make an impact
 

Required Qualifications

• Bachelors or better in Health Administration or related field.
• 2+ Years of Management Experience in Managed Care or Income Maintenance.
• Proficiency in Microsoft Excel- creating, manipulating, extracting data, V lookup, etc.
• Reside within the State of WI or within reasonable commuting distance

 

Preferred Qualifications

• Prior Eligibility experience.

Additional Information

• Workstyle: This is a hybrid/ home position.
• Typical Work Days/Hours: Monday – Friday, 8:00 am – 4:30 pm CST

WAH Internet Statement

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

• At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
• Satellite, cellular and microwave connection can be used only if approved by leadership.
• Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
• Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Benefits

Humana offers a variety of benefits to promote the best health and well-being of our employees and their families. We design competitive and flexible packages to give our employees a sense of financial security—both today and in the future, including:

• Health benefits effective day 1
• Paid time off, holidays, volunteer time and jury duty pay
• Recognition pay
• 401(k) retirement savings plan with employer match
• Tuition assistance
• Scholarships for eligible dependents
• Parental and caregiver leave
• Employee charity matching program
• Network Resource Groups (NRGs)
• Career development opportunities

HireVue

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

SSN Alert

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

 

$57,700 - $79,500 per year

 

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us
 

About Inclusa: Inclusa manages the provision of a person-centered and community-focused approach to long-term care services and support to Family Care members across the state of Wisconsin. As a values-based organization devoted to building vibrant and inclusive communities, Inclusa deploys a unique approach to managed care with a trademarked model of support named Commonunity® which focuses on the belief in everyone, and from that belief, the common good for all is achieved. In 2022, Inclusa was acquired by Humana. This partnership will allow us to create a model of care that provides industry-leading support for members across the health care continuum.

About Humana: Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers, and our company. Through our Humana insurance services, and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or veteran status. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.