Employee Benefits Account Manager

Benefit Eligibility & Reimbursement Social Worker The Massachusetts Department of Public Health (DPH) at Tewksbury Hospital is seeking an experienced leader to serve as the Benefit Eligibility & Referral Social Worker Supervisor (BERS Social Worker C). In this role, you will lead a dedicated team responsible for helping patients and long-term care residents navigate complex financial, insurance, and public benefit programs that support access to essential healthcare services. This is a great opportunity for a collaborative professional who enjoys mentoring staff, improving processes, and solving complex eligibility and financial counseling challenges. You will work closely with interdisciplinary healthcare teams, hospital leadership, MassHealth, Social Security, and community partners to remove barriers to treatment, strengthen patient outcomes, and support efficient hospital operations. DPH offers a mission-driven environment where your leadership will directly improve the lives of vulnerable individuals while providing opportunities for professional growth, meaningful collaboration, and public service. Duties and Responsibilities: Provides day-to-day supervision and guidance to Benefits Eligibility & Referral Social Worker (A/B) staff performing financial counseling, private-pay assessments, registration, insurance verification, and encounter billing. Monitors the timeliness and accuracy of financial counseling and private-pay assessments, ensuring consistent use of the hospital sliding fee scale and clear documentation of financial recommendations. Oversees registration workflows for new and returning patients, verifying that demographic, contact, insurance, and guarantor information is properly collected and updated in applicable systems. Develops, implements, and maintains standardized processes, templates, and tracking tools for MassHealth LTC applications, renewals, and related activities to promote timeliness and consistency. Provides advanced consultation to staff on complex Social Security and federal benefit matters, including SSI/SSDI eligibility, overpayments, appeals, suspensions, and reinstatements. Designs and maintains department-level tracking systems (e.g., spreadsheets, databases, dashboards) to monitor MassHealth eligibility, applications in progress, SC-1 activity, redeterminations, and key deadlines. Provides oversight and consultation on cases involving immigration status and USCIS processes, ensuring that staff appropriately identify immigration-related barriers that affect benefits and discharge planning. Oversees staff review of Personal Needs Accounts (PNA) balances and asset levels to identify patients exceeding allowable benefit thresholds. Oversees staff management of SORB-related requirements, including tracking of annual fees, reporting obligations, and documentation requirements for designated patients. Oversees staff completion of Disabled Persons Protection Commission (DPPC) reports, ensuring that mandated reporting requirements are understood and consistently met. Required Qualifications: Knowledge of the methods and standards of general report writing. Ability to read, interpret, apply, and explain laws, rules, regulations, policies, procedures, specifications, standards, and guidelines governing assigned areas. Ability to gather information through questioning and by examining records and documents. Ability to conduct interviews effectively and professionally. Ability to accurately record information provided orally. Ability to communicate clearly and effectively, both orally and in writing. Ability to write concisely, express thoughts clearly, and develop ideas in logical sequence. Ability to maintain accurate and organized records. Ability to perform arithmetic computations with speed and accuracy. Ability to assemble items of information in accordance with established procedures. Preferred Qualifications: Experience supervising staff in a healthcare, hospital, long-term care, or human services setting. Strong knowledge of MassHealth/Medicaid, Medicare, commercial insurance, and benefit eligibility programs. Experience managing long-term care (LTC) MassHealth applications, renewals, and appeals. Familiarity with Social Security (SSI/SSDI), disability benefits, and other federal assistance programs. Experience interpreting and applying state and federal healthcare regulations, including HIPAA and eligibility requirements. Demonstrated ability to analyze complex financial or benefit eligibility cases and develop effective solutions. Experience collaborating with interdisciplinary healthcare teams to support patient care and discharge planning. Proficiency with electronic health records, eligibility verification systems, databases, and Microsoft Office applications, including Excel. Excellent leadership, communication, organizational, and customer service skills with a commitment to promoting equitable access to healthcare services. About the Department of Public Health: The mission of the Massachusetts Department of Public Health (DPH) is to prevent illness, injury, and premature death, to assure access to high-quality public health and health care services, and to promote wellness and health equity for all people in the Commonwealth. We envision a Commonwealth in which all people enjoy optimal health. Massachusetts ranks among the healthiest states according to comparative analyses, but we face numerous challenges, including chronic and infectious disease, substance abuse, violence, preventable hospitalizations, and health disparities. DPH coordinates programs and policies to address specific diseases and conditions and offer services to address the needs of vulnerable populations. We also develop, implement, promote, and enforce regulations and policies to assure that the conditions under which people live are most conducive to health and enable people to make healthy choices for themselves and their families. We license health professionals, healthcare facilities and a variety of businesses that impact public health. We operate the state laboratory and four public health hospitals. We monitor health status and manage vital records including births, marriages and deaths. We educate people about public health issues and work closely with local boards of health and community partners to identify and solve public health problems. About Tewksbury Hospital: Tewksbury Hospital offers a broad range of services including a physician on site at all times, around-the-clock nursing care, rehabilitation services including physical therapy, occupational therapy, and speech therapy, psychology services, social services, nutritional services, and an on-site dialysis clinic.