Michael Kirshy
Roseville,CA
Summary
Results-driven leader in eligibility and case management, recognized for enhancing compliance and operational efficiency at Placer County Health and Human Services. Proven expertise in conflict resolution and critical thinking, combined with strong team collaboration and customer service skills that significantly improve process outcomes. Proficient in data entry and active listening, ensuring meticulous attention to detail fosters effective communication. Committed to leveraging these competencies to drive continued organizational success.
Overview
18
18
years of professional experience
Work History
Senior Eligibility Specialist
Placer County Health and Human Services
Rocklin, CA
02.2023 - Current
- Responsibilities include, but are not limited to: review, research, analysis, and position statement report preparation and presentation activities, as well as functions related to state hearings for the County of Placer for Medi-Cal and General Relief programs.
- Determining the appropriateness of departmental action taken, representing the department and other counties at hearings involving binding agreements and stipulations, reviewing staff decisions, and determining the need for and implementing conditional withdrawal, as appropriate.
- Required to implement hearing decisions, and monitor post-hearing for compliance and submission to the state.
- Required to enter information into CalSAWS to document pre- and post-hearing actions.
- Expectation is managing the resolution process for fair hearings at the lowest administrative level possible; therefore, reducing the overall costs by foregoing a fair hearing while making sure that our stance is parallel to the letter of the law.
- Work closely with staff and supervisors regarding all hearings being submitted.
Eligibility Specialist II
Placer County Health and Human Services
Rocklin , CA
01.2017 - 02.2023
- Interview applicants for, and participants in, designated client services programs and services; assist applicants in the completion of appropriate applications, financial disclosures, and declaration forms necessary to process the application; determine and request necessary verification and data to accurately evaluate the applicant's or client's eligibility, and determine the applicant's or participant's eligibility for designated program(s).
- Interpret and explain designated program(s), regulations, obligations, procedures, and other pertinent information on an individual basis, in person, by telephone, or in group settings to applicants, participants, and the general public.
- Educate, recommend, and determine initial and continuing eligibility in accordance with established procedures for various assigned programs, including verification of reported information and benefits provided by other jurisdictions; screen applicants/participants to determine eligibility for expedited, expanded, and/or modified services.
- Maintain appropriate and accurate case records, documentation, and files, including performing data entry into automated record systems; monitor and follow up on due dates; prepare and maintain other documents associated with designated program area(s) and related reporting requirements.
- Recognize the need for, and provide referrals to, other client services and/or community resources/agencies to assist applicants/participants in identifying and utilizing the resources and services available; establish and maintain liaison with local, private, and public resources to provide continuity of services and awareness of designated program area(s).
- Build and maintain positive working relationships with co-workers, other County employees, community agencies and resources, and the public, utilizing principles of effective customer service.
Owner
Pinot's Palette
Rocklin, CA
01.2015 - 02.2017
- Used excellent verbal skills to engage customers in conversation and effectively determine needs and requirements.
- Developed policies and procedures for the organization.
- Created and implemented employee onboarding and training programs to promote employee retention and team collaboration.
- Provided direction and guidance to employees.
- Analyzed market trends to identify new business opportunities.
- Promoted business on social media platforms to maximize brand identity and generate revenue.
- Ensured compliance with applicable laws and regulations related to business operations.
- Executed performance reviews to encourage improved productivity for team members.
- Collaborated with other owners on joint ventures and shared resources.
- Organized events such as trade shows and conferences.
- Implemented campaigns and promotions to help with developing goods and services.
- Monitored progress by establishing plans, budgets and measuring results.
- Created marketing campaigns to attract new customers.
- Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.
- Conducted performance reviews for employees on a regular basis.
- Prepared weekly schedules to verify proper floor coverage within fiscal guidelines.
- Supervised performance of workers with goals of improving productivity, efficiency and cost savings.
- Maintained relationships with existing clients by providing superior customer service.
Eligibility Specialist I
Placer County Health and Human Services
Rocklin, CA
01.2013 - 01.2015
- Maintained positive working relationship with fellow staff and management.
- Interview applicants for, and participants in, designated client services programs and services; assist applicants in the completion of appropriate applications, financial disclosures, and declaration forms necessary to process the application; determine and request necessary verification and data to accurately evaluate the applicant's or client's eligibility, and determine the applicant's or participant's eligibility for designated program(s).
- Interpret and explain designated program(s), regulations, obligations, procedures, and other pertinent information on an individual basis, in person, by telephone, or in group settings to applicants, participants, and the general public.
- Educate, recommend, and determine initial and continuing eligibility in accordance with established procedures for various assigned programs, including verification of reported information and benefits provided by other jurisdictions; screen applicants/participants to determine eligibility for expedited, expanded, and/or modified services.
- Maintain appropriate and accurate case records, documentation, and files, including performing data entry into automated record systems; monitor and follow up on due dates; prepare and maintain other documents associated with designated program area(s) and related reporting requirements.
- Recognize the need for, and provide referrals to, other client services and/or community resources/agencies to assist applicants/participants in identifying and utilizing the resources and services available; establish and maintain liaison with local, private, and public resources to provide continuity of services and awareness of designated program area(s).
Sales Manager
24 Hour Fitness
Folsom, CA
01.2007 - 01.2013
- Resolved customer complaints regarding sales and service.
- Met with sales and design departments to determine project road maps and create unique products to drive profitability and champion brand.
- Improved profit margins by effectively managing expenses, budget and overhead, increasing closings and optimizing product turns.
- Established relationships with key clients, while maintaining existing customer base.
- Identified and developed new markets for products or services.
- Supported sales team members to drive growth and development.
- Established ambitious goals for employees to promote achievement and surpass business targets.
- Conducted regular meetings with staff members to review goals and objectives for the quarter and year.
- Created and presented monthly reports to management on sales performance.
Education
Some College (No Degree) - Business
American River College
Sacramento, CASkills
- Eligibility Analysis
- Regulatory compliance
- Data entry
- Case management
- Hearing representation
- Customer service
- Policy interpretation
- Conflict resolution
- Team collaboration
- Critical thinking
- Medi-Cal
- Effective communication skills
- Verbal communication
- Decision-making
- Professionalism
- Active listening
- Problem-solving aptitude
- Teamwork and collaboration
- Effective communication
- Detail orientation
References
References available upon request.
Timeline
Senior Eligibility Specialist
Placer County Health and Human Services
02.2023 - Current
Eligibility Specialist II
Placer County Health and Human Services
01.2017 - 02.2023
Owner
Pinot's Palette
01.2015 - 02.2017
Eligibility Specialist I
Placer County Health and Human Services
01.2013 - 01.2015
Sales Manager
24 Hour Fitness
01.2007 - 01.2013
Some College (No Degree) - Business
American River College
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