Eligibility and Policy Program Manager

2 months ago

Atlanta, Georgia, United States GeorgiaGov Full time

**Job Summary**

The Eligibility and Policy Analyst plays a critical role in ensuring the smooth operation of Georgia Access – State Based Exchange. This position is responsible for reviewing and updating program policies and operational procedures to ensure compliance and efficiency.

**Key Responsibilities**

  • Analyze customer issues to determine causes and develop new processes to resolve them.
  • 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.
  • Draft, review, and update the Contact Center's consumer support materials, such as scripts and Interactive Voice Response (IVR).
  • Review, respond to, 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**

  • 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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