Under supervision, the Eligibility and Policy Analyst is responsible for reviewing and updating program policies and operational procedures for the implementation and ongoing operations of Georgia Access – State Based Exchange. 

Analyzes customer issues to determine causes and develops new processes, documenting changes, and new steps as developed.

Reviews and updates consumer eligibility, verification, and appeals policies for the Georgia Access division. 

Supports and participates in the annual federal programmatic audit and any other audits, as needed.

Analyzes the Contact Center’s metrics, Key Performance Indicators (KPIs), and related reports produced by the Contact Center vendor. 

Prepares draft recommendations for the Contact Center Specialist to improve Contact Center processes, including metrics and KPIs; develop reports or dashboards as needed.

Drafts, reviews, and updates the Contact Center’s consumer support materials (e.g., scripts and Interactive Voice Response (IVR)).

Reviews, responds and/or resolves escalated Contact Center inquiries and appeals reported by consumers, agents, and private-sector partners.

Coordinates with the agency’s Administrative Procedures department for eligibility appeals.

Develops private-sector partner and assister (Navigators and CACs) policies and business requirements.

Works with other state agencies as necessary, such as the Department of Human Services (DHS) and Department of Community Health (DCH), for referrals of consumers to/from Medicaid and Georgia Access.

Performs other duties assigned.