Job Description

Description and Functions

Open Until Filled

GENERAL DESCRIPTION:

The HCBS Benefits and Eligibility Manager is responsible for providing oversight to a team of 12 FTEs responsible for determining eligibility, reviewing plans of care, and providing oversight and support to case managers in their development of the plan of care and ongoing support for the HCBS program participants. This function is critical to ensuring approximately 5,000 program participants receive quality services in a timely manner.

This position is responsible for managing the plan of care development process, including the quality assurance review process and oversight of the provision of technical assistance to case managers as they complete plans of care. This position develops and manages the implementation of new policies and procedures resulting from changes in federal and state regulatory requirements. A vital component of this position is to review plan of care data to identify trends and provide recommendations to alleviate any problems noted.

This position is a part of the HCBS Section Leadership Team, contributing to the growth and development of the program, has input into the strategic vision of the HCBS Section, and represents the HCBS Section at stakeholder meetings, training sessions, and in other appropriate venues.

Human Resource Contact:

ESSENTIAL FUNCTIONS: The listed functions are illustrative only and are not intended to describe every function which may be performed at the job level.

• Oversight and Management of Benefits and Eligibility Staff of 12 FTEs: Responsibility for oversight of work product the Benefits and Eligibility Team. Responsible for training and professional development of staff; facilitation of meetings and conversations; problem-solving; conflict resolution; completion of personnel issues including performance evaluations, personnel concerns, and disciplinary action; interprets rules, policies, and procedures for staff when complex issues arise; responsible for coordinating feedback to stakeholder questions and concerns with other Units within the HCBS Section.
• Oversight of benefit and eligibility component compliance with state and federal regulation, including case manager compliance: Identifies policies and processes to revise based on changes to federal and state regulation, and identifies gaps in current policies and processes regarding the needs of participants and stakeholders. Coordinates with Policy and Communications Unit to facilitate development, implementation, and updates to policies and processes. Facilitates internal and external training regarding relevant topics for case manager support, participant support, and plan of care-related issues
• Guidance and vision for Unit as a part of the overall HCBS Section Leadership team: Serves as a member of the HCBS Section leadership team, contributing to Section priorities and projects. Provides data, information, and expertise to the HCBS Section leadership team to assist in decision-making. Participates in key roles in project planning and project execution to ensure the implementation of federal and state requirements.
• Provides guidance and oversight to plan development and review function: Direct and oversee the process by which plans of care are developed and reviewed, ensuring compliance with rules and with federal requirements. Analyze, review, and report results to appropriate internal and external stakeholders. Oversee case management development and review of plans, and provide responsive customer service and support related to plan development, plan renewal, and other plan of care support as a part of a continuum of HCBS services and supports.
• Oversight of resource allocation processes: Direct and manage processes by which resources are allocated to participants, including but not limited to monitoring the ICAP contract for the level of care assessments, as well as assisting in any other RFPs and contracts related to the benefits and eligibility program element; overseeing the Extraordinary Care Committee (ECC) process; overseeing eligibility assessments and processes; overseeing various budget methodologies for Individualized Budget Amounts (IBAs). Ensure program rules and policies are applied consistently in the management of these processes, and represent the HCBS Section at administrative hearings related to these processes.
• Relationship building and representation of HCBS Section: Attendance at relevant advisory council, partnership meetings, and other stakeholder meetings. Facilitate conversation and information for providers, case managers, participants, family members, and other stakeholders

Qualifications

PREFERENCES:

Preference will be given to candidates with a Master\'s degree in public administration, health administration, or related fields.

KNOWLEDGE:

• Excellent customer service skills, including skills in conflict resolution.
• Facilitation skills, including public speaking and meeting facilitation.
• Strength in verbal and written communications, including experience presenting to large and small audiences, and facilitation of training events.
• Ability to navigate difficult conversations including individuals with conflicting and competing priorities.
• Ability to deliver effective coaching and supervision, both in person and remotely.

MINIMUM QUALIFICATIONS:

Education:

Bachelor\'s Degree (typically in Healthcare)

Experience:

2-4 years of progressive work experience (typically in Health Programs) with acquired knowledge at the level of a Health Program Manager I

OR

Education & Experience Substitution:

5-7 years of progressive work experience (typically in Health Programs) with acquired knowledge at the level of a Health Program Manager I

Certificates, Licenses, Registrations:

None

Necessary Special Requirements

PHYSICAL WORKING CONDITIONS:

• Typically, the employee will sit comfortably to perform the work.
• There may be some walking, standing, bending, and carrying light items

NOTES:

• FLSA: Exempt
• The Wyoming Department of Health is an

employer.

Supplemental Information

048-Wyoming Department of Health - Division of Healthcare Financing

Click to view the State of Wyoming Classification and Pay Structure.

URL:

The State of Wyoming is an Equal Opportunity Employer and actively supports the ADA and reasonably accommodates qualified applicants with disabilities.

Class Specifications are subject to change, please refer to the A & I HRD Website to ensure that you have the most recent version.

There are many benefits to living and working in Wyoming. Beautiful country with wide-open spaces and clean air, great recreational opportunities, and no State income tax to mention a few! In addition, the State of Wyoming offers State employees a very generous benefits package. Please for more information on the State of Wyoming employee benefits*.

For additional information on living in the state of Wyoming please .

State of Wyoming