Eligibility Manager

Company: Trustmark
Location: West Des Moines
Posted on: May 15, 2022

Job Description:

Join a passionate and purpose-driven team of colleagues who contribute to Trustmark's mission of helping people increase wellbeing through better health and greater financial security. At Trustmark, you'll work collaboratively to transform lives and help people, communities and businesses thrive. Flourish in a culture where appreciation, mutual respect and trust are constants, not just for our customers but for ourselves.

For more than four decades, Trustmark Health Benefits has crafted integrated, flexible, and tailored employer health plan designs that seamlessly meet specific business needs and delight members. Each of our offices around the country is managed locally, by industry veterans who understand the dynamics of the markets they serve. Our responsive and empathetic service teams provide the highest level of support for employers and members. Our local expertise and service represents our national strength. We are an independently operated subsidiary of Trustmark Mutual Holding Company.

Trustmark Health Benefits is currently seeking an Eligibility Manager . The Eligibility Manager is responsible for the day-to-day supervision, leadership, and management of a team, or multiple teams, in two or more Health Benefits locations. Manager will enable the team to meet our client and corporate commitments. Responsibilities include, but are not limited to, successful achievement of team quality, production and service expectations, staff development, successful implementation of new clients, and retention of existing clients. The Manager is responsible for coaching, answering complex or difficult questions, advising team members regarding processes and procedures, and providing support to ensure all department goals are met. The Manager is expected to have greater visibility and accountability than a Supervisor including providing advanced technical guidance on Dependent Eligibility Audits, Electronic Eligibility, ID cards and Automated Enrollment and may act as a Subject Matter Expert for related projects and initiatives.

Please note that after training, you will be working in a hybrid capacity working 2 days in the office and 3 days remotely.

KEY ACCOUNTABILITIES:

- Plan, direct and manage the work of the team. Adjust hours and/or staff assignments as needed based on staff availability and business need. Take corrective action as necessary
- Manage, monitor, track and report performance of staff to ensure inventory, turnaround time, production, quality and service objectives are achieved. Establish and implement workflow management processes.
- Create, manage, and run recurring and custom reports as required to manage work, resolve issues, and report performance.
- Provide timely and accurate information regarding client, Health Benefits or Compliance updates that impact team.
- Lead, implement, manage, and successfully complete Dependent Audit Projects:
o Interface directly with the client (employer), to obtain agreement with the process and timeframes
o Ensure staffing levels and metrics are agreed upon and documented
o Continue to work with Employer providing updates, negotiate changes as needed
- Serve as a resource/SME for team members and projects on all aspects of Eligibility including, but not limited to Dependent Eligibility Audits, Electronic Eligibility, automated enrollment, Real Time Eligibility, ID cards, in addition to manual enrollment.
- Work with other functional teams to collaborate and provide feedback on process and system improvements e.g. Triple E, Portal, Claims, Finance, Pre-processing, and so
- Responsible for building positive and collaborative relationships with clients, team members , other functions within the organization, and vendors to provide Eligibility and related expertise daily for questions and problem resolution as well as proactively during group implementations and open enrollment.
- Responsible for clearly communicating expectations and goals to team members and creating a culture of accountability for their work, mentoring and development of staff members, and completing performance appraisals.
- Handle personnel matters including mentoring, coaching, motivating, performance management and feedback, recognition, performance evaluation and time tracking of direct reports.
- Provide input into compensation and promotion increases.
- Regularly communicate with staff via department meetings and one-on-one meetings with team members
- Mentor and develop leaders within team.
- Interview and recommend viable candidates for job openings.
- Collaborate with location/region Trainers to orient and develop new staff, assess performance and training needs, timely and effectively implement new policy and procedure, assess ongoing training needs, and provide training, as needed.
- Resolve client or member/employee escalated issues
- Work with other departments and vendors as needed to resolve escalated issues.
- Recommend changes to resolve repetitive issues.
- Interface with Client Management Team, other functions and vendors to ensure successful implementation of new clients, and retention of existing clients, from an eligibility perspective.
- Effectively communicate and advise staff on client requirements and unique client handling to ensure proper eligibility management. Participate in or oversee User Testing to eligibility is set-up correctly.
- Participate in client meetings or sales presentations as needed
- Other duties as needed/assigned.

EDUCATION AND EXPERIENCE:

- High School Diploma or GED equivalent
- 3-5 years Eligibility experience
- Eligibility Supervisor Experience
- Self-directed individual who works well with minimal supervision
- Excellent verbal and written communication skills
- Strong leadership, organizational and interpersonal skills
- Ability to work effectively with employees/members, providers, clients and differing levels of co-workers including Client Managers and all levels of staff
- Ability to use common sense understanding to carry out instructions furnished in oral, written or diagram form
- Ability to effectively deal with problems in varying situations and reach resolution
- Ability to read, analyze and interpret documents and Summary Plan Descriptions (SPDs)
- Flexible; open to continued process improvement
- Bachelor's degree preferred
- Self-Funded Insurance/Benefits and/or TPA experience preferred

Keywords: Trustmark, West Des Moines , Eligibility Manager, Executive , West Des Moines, Iowa