Eligibility Manager

Eligibility Manager

The mission of One Community Health is to transform lives through care, research, and community awareness. This position will support the goals of this mission by providing assistance to patients in securing insurance eligibility. This position supports key eligibility initiatives as required by funding sources and organizational mission.

Location : This role is located in Midtown - Sacramento, CA (95811).

Essential Functions

• Provides guidance to staff to accurately determine and verify eligibility for Federal / State / County programs / grants / health insurance such as Family Pact, Sliding Fee Discount Program, Medi-Cal, Medicare, Covered California, Ryan White, ADAP and other essential organizational programs, which requires patient eligibility verifications.
• Keep up to date with the latest program changes and ensure staff is properly notified and trained.
• Oversee the Eligibility operations; manage the daily staff schedules, tasks, special projects and monitor department workflows, processes, and productivity.
• Engage staff to promote pride and ownership in One Community Health's mission and work quality.
• Provide exceptional customer service by working with patients to meet their needs.
• Supervises and trains staff to create a welcoming environment for all new patients and renewal appointments.
• Collaborate internally across departments to identify best practices to deliver the best service to our patients.
• Must have a solid understanding of insurance programs, Federal Sliding Fee Discount program and State and Federal regulations and the Revenue Cycle.
• Actively engage quality assurance activities to improve and maintain excellent customer service levels.
• Provide feedback to staff and leadership on data trends with actionable recommendations.
• Monitor the compliance of staff with Federal / State / County / Organizational policies and procedures for program eligibility.
• Collaborate across departments to ensure accurate information is collected, entered, and reported to grant funders and regulatory entities.
• Monitor Eligibility staff is accurately following established workflows and entering data in a timely manner to ensure data integrity.

Minimum Requirements

Preferred Background

One Community Health endorses and supports the Americans with Disabilities Act of 1990 (ADA) and the California Fair Employment and Housing Act (FEHA) and is committed to providing reasonable accommodations to qualified individuals with disabilities who are applicants or employees who need accommodations. If you require an accommodation due to a disability to complete this application or you are experiencing difficulty submitting your application, please contact us at ochhumanresources@onecommunityhealth.com.