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Eligibility Unit Manager
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- This position is responsible for directing, managing, and coordinating all activities of: Medicaid Eligibility Quality Control, Payment Error Rate Measurement, Medicaid Eligibility Quality Assurance Monitoring, Investigations into suspected Medicaid Member Fraud, Waste, and Abuse, and confirming the Wyoming Medicaid and KidCare Childrens Health Insurance Program (CHIP) are administered in compliance with all federal and state eligibility rules, regulations, policies, and procedures.
- Participates in administrative planning to advise and support continuous improvement efforts through the development of new monitoring tools, system enhancements, outreach, or other opportunities that impact Medicaid eligibility determination quality improvement outcomes.
- Makes recommendations to the Eligibility and Client Services Section, Eligibility and Client Services Section Administrator, the Senior Eligibility Manager, Vendor Contract Managers, and the Benefits Coordination Manager as needed, to confirm Medicaid eligibility determinations are meeting the goals of the program.
- Participates in developing and monitoring Medicaid eligibility quality assurance monitoring goals and performance measures.
- Works with direct reports to create policies and procedures for the completion of Medicaid Eligibility Quality Control and Quality Monitoring activities.
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