Eligibility and Policy Specialist

2 weeks ago


Atlanta, Georgia, United States GeorgiaGov Full time
Job Summary

We are seeking a highly skilled Eligibility and Policy Analyst to join our team at GeorgiaGov. The successful candidate will be responsible for reviewing and updating program policies and operational procedures for the implementation and ongoing operations of Georgia Access – State Based Exchange.

Key Responsibilities
  • Analyze customer issues to determine causes and develop new processes, documenting changes and new steps as developed.
  • Review and update consumer eligibility, verification, and appeals policies for the Georgia Access division.
  • Support and participate in the annual federal programmatic audit and any other audits, as needed.
  • Analyze the Contact Center's metrics, Key Performance Indicators (KPIs), and related reports produced by the Contact Center vendor.
  • Prepare draft recommendations for the Contact Center Specialist to improve Contact Center processes, including metrics and KPIs; develop reports or dashboards as needed.
  • Draft, review, and update the Contact Center's consumer support materials (e.g., scripts and Interactive Voice Response (IVR)).
  • Review, respond, and/or resolve escalated Contact Center inquiries and appeals reported by consumers, agents, and private-sector partners.
  • Coordinate with the agency's Administrative Procedures department for eligibility appeals.
  • Develop private-sector partner and assister (Navigators and CACs) policies and business requirements.
  • Work with other state agencies as necessary, such as the Department of Human Services (DHS) and Department of Community Health (DCH), for referrals of consumers to/from Medicaid and Georgia Access.
  • Perform other duties assigned.
Requirements

A Master's degree in a related field from an accredited college or university OR Bachelor's degree in a related field from an accredited college or university AND Two years of related experience OR Associate's degree in a related field from an accredited college or university AND Three years of related experience OR Four years of related professional experience. Note: Some positions may require a certification or licensure. Note: Some positions may require a valid driver's license.



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