PL 001 ELIG OPS STAT DATA.docx

This is an operational data report for South Carolina's Medicaid Eligibility Operations Services, documenting performance metrics and staffing levels for the 2019-2020 fiscal periods. The report tracks applications received, outbound call volumes, and personnel allocation across the eligibility operations team. In 2019, the operations received 76,079 total applications across the September-December period, with a corresponding 4,221 outbound calls made during the same timeframe. In 2020, applications received decreased to 34,961 total applications, while outbound calls increased to 5,079 during the September-December period. The staffing structure remained consistent between years, comprising 3 managers, 1 team lead, and combined customer service agents and claim clerks totaling 54-55 positions.

Staffing vacancy rates improved from 2019 to 2020, with customer service agent vacancies declining from four to one position and claim clerk vacancies reducing from eight to three positions. In 2019, the team operated with 29 of 33 customer service agents filled and 14 of 22 claim clerks filled. By 2020, these figures improved to 31 of 32 customer service agents and 18 of 21 claim clerks, indicating enhanced capacity utilization. Managerial and team lead positions maintained full staffing throughout both periods with no vacancies. The data demonstrates the operational demands placed on eligibility services, with monthly applications ranging from 7,869 to 20,875 in 2019 and 7,946 to 9,838 in 2020, requiring consistent staffing resources to process applications, conduct outbound communications, and manage data entry functions.