Eligibility & Financial Screening Manager

Overview

This role is responsible for the day-to-day operational management and strategic direction of eligibility determination, financial screening, application assistance and enrollment services for local, state, and federally funded healthcare programs. Depending on the unit, this includes supervising and supporting staff located at Central Health and CommUnityCare clinic sites, the Central Health Navigation Center, and in community-based settings, ensuring consistent delivery of high-quality services to clients. This position is responsible for fostering a team-based approach to achieving departmental objectives, promoting a positive and supportive work culture, and ensuring consistent delivery of high-quality services across all service locations. The role oversees onsite scheduling to maintain appropriate coverage, monitors backend workflows to support timely application processing, and upholds alignment with service performance standards. This position leads staff recruitment, onboarding, and performance management, while also contributing to budget planning, staffing assessments, and long-term capacity planning.

The Eligibility and Financial Screening Manager leads a diverse team that includes Eligibility and Financial Screening Supervisors, Specialists and Associates. This position requires strong leadership, strategic thinking, operational management, and communication skills, along with a demonstrated ability to guide staff and processes in a dynamic, client-centered healthcare environment.

Responsibilities

Essential Functions:

• Oversee the daily operations of eligibility and financial screening services, ensuring consistent delivery of high quality, client-centered support across all service locations.

• Manage team schedules to maintain appropriate onsite coverage and monitor back-end workflows to ensure timely processing of applications and alignment with performance standards.

• Coordinate recruitment, hiring, and onboarding of staff; oversee timesheet management, 90-day evaluations, and annual performance reviews for all assigned team members.

• Identify, implement, and evaluate changes to processes and procedures that improve program efficiency, compliance, and quality of service delivery.

• Monitor changes to regulatory guidelines and requirements; lead the integration of these changes into daily operations, including updates to automated tools and standard operating procedures. 

• Manage the completion of file reviews and performance reports to support compliance with internal policies and external regulatory standards.

• Collaborate with other units within the Eligibility and Financial Screening Department and internal departments, including Central Health and CommUnityCare clinics and the Navigation Center to ensure program goals are met and staff have the tools and support needed for success.

• Maintain strict confidentiality of protected health information (PHI) and uphold all organizational policies, procedures, and service standards.

• Attend community events and represent the organization as needed including evenings and weekends

• Uphold the organization's values by consistently demonstrating professionalism in all actions, job performance, personal conduct, and communications.

• Perform other related duties as assigned.

Knowledge, Skills and Abilities:

• Demonstrated ability to plan, organize, and manage time effectively, including prioritizing multiple tasks, meeting deadlines, and maintaining accuracy in a high-volume environment.
• Skilled in coaching, training, and motivating team members to achieve performance benchmarks and operational goals.
• Ability to analyze operational and administrative data to identify improvement opportunities and implement process enhancements.
• Proven experience in delivering exceptional customer service and engaging with the public in a professional and compassionate manner.
• Bilingual proficiency in English and Spanish highly preferred, with the ability to communicate clearly across diverse populations.
• Strong knowledge of financial eligibility procedures and compliance requirements related to regulatory programs and specialty grants such as Ryan White, Title V, PHC, and Family Planning.
• Knowledge of local, state, and federal healthcare coverage programs, including Medicaid, CHIP, and other publicly funded health plans.
• Proficient in the use of eligibility and healthcare systems, including EPIC, eligibility software platforms (VeritySource preferred), Microsoft Office Suite, Excel, and Adobe Pro.

Qualifications

Minimum Education:

• High School Diploma or equivalent (higher degree accepted) 

Minimum Experience:

• 3 years Experience working in health care, government, nonprofit, or a customer service industry. Required
• 2 years Experience in a leadership or supervisory role. Required
• Experience and knowledge of financial eligibility processes and standards, and of government health insurance eligibility criteria and the application processes.

Required Licenses and Certifications:

• ACA Certification within 6 months of hire
• Community Partner Program Certification within 6 months of hire
• Data Security Certification within 6 months of hire