Adult Medicaid Long Term Care - Eligibility Team Lead

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Job Information

Title:

Adult Medicaid Long Term Care - Eligibility Team Lead

Market Range:

MR16

Approved Date:

2/19/2024 11:56:15 AM

FLSA:

Non-Exempt

EEO Code:

PROFESSIONALS

Career Level:

C4

Career Level Description:

Core Services Level 4

Job Code:

100022

Job Family:

Social Services

Sub Family:

Economic Services

Primary Purpose

Works as lead worker/team lead in Adult Medicaid, Long Term Care and Special Assistance program. Performs consultative, technical and administrative work in the planning, implementation and monitoring of Long Term Care and Special Assistance services and staff's work. Provides an advanced level of program assistance to clients and caseworker staff Requires constant communication with Medicaid applicants and family members, outside agencies, attorneys, and hospital and facility representatives.

•

Delivers assistance to caseworkers; provides advanced level of program assistance to clients and caseworkers - troubleshoots cases, explains policy decisions and interpretation of policy.

1

20%

•

Contacts clients and gathers needed documents, assesses information provided to determine benefits - enters required data and documentation into online and electronic systems to determine eligibility as this position carries a small caseload.

2

20%

•

Completes applications/cases for absent staff, staff on leave, and vacancies, as well as works late applications/cases.

3

15%

•

Conducts quality assurance reviews for caseworkers.

4

10%

•

Trains staff who require attention and provides ongoing instruction as directed on new policies, policy clarifications or on policy/procedure identified through the QA process.

5

15%

•

Provides assistance and training for new staff by having one-on-one training and being available to provide guidance and support on a daily basis.

6

15%

•

Assigns work to caseworkers by completing daily Excel spreadsheet report using the data from O&M report and NCFast. Completes assignments spreadsheet. Monitors pending applications/cases and identifies issues within reports.

7

5%

Position(s) may perform other duties in addition to the above as assigned by management.

•

Prepares presentation and training materials, including cheat sheets and easy-to-follow guidance.

•

Acts as a local hearing officer for Adult Medicaid, Long Term Care and Special Assistance cases.

•

Supports supervisors by monitoring O&M reports, completing duty schedules, working tasks/holds and other duties as assigned.

•

Works NCFast reports and queues as directed, assists with troubleshooting Medicaid cases.

•

Travels to regional offices throughout the county on a periodic basis.

*IMPORTANT* In the event of an emergency, as determined by the County Manager or designee, participation in preparedness and response operations should be expected. Employee may be required to fill a temporary assignment in a role different from standard duties, work hours and/or work location in preparation for, during and after the emergency. Employee may also be required to participate in relevant exercises and regular preparedness training.

Career Level Dimensions

Career Level:

C4

Career Level Description:

Core Services Level 4

•

Works to complete tasks and achieve operational targets that impact the performance of the Work Group.

•

May require leading, delegating, and reviewing the work of other employees.

•

Responsible for making adjustments or recommending enhancements to systems or processes to solve problems or improve effectiveness of the Work Group.

•

Expected to independently propose solutions to problems for supervisor or manager review.

•

Communicates within and outside Work Group to obtain or provide information for matters of moderate importance.  Explains practices and policies to reach agreement.

•

May act as a team lead and assistant to the supervisor/manager. May delegate tasks to other team members and be responsible for the review of work product.

•

Does not have formal management responsibilities (e.g., performance management, disciplining, etc.), but may provide input to leadership in Work Group.

•

Requires advanced knowledge within a specific discipline typically gained through extensive work experience, technical training, and/or advanced education.

Qualifications

•

Associate's degree in Human Services or a related field

•

Three years of job-related experience

•

Equivalent education and experience are accepted

•

2 Years

Adult Medicaid, Long Term Care, Special Assistance and/or Community Alternatives Program Experience.

And

•

2 Years

Experience determining eligibility for a State or County Department of Social Services program (Medicaid, Food and Nutrition Services, Work First, Child Care Subsidy, Child Support, WIC or Energy Assistance Program).

And

•

2 Years

Experience with office equipment and other relevant technology (software and systems) to meet business needs (e.g., Microsoft Office, NC FAST, and electronic document management system).

•

Knowledge of principles and processes for providing customer and personal services. This includes customer needs assessment, meeting quality standards for services, and evaluation of customer satisfaction.

•

Excellent written and verbal communication skills.

•

Applies complex policy to determine client eligibility, instructs staff in determining eligibility and monitors eligibility determinations. 

•

Plans and supports the development of others. Identifies knowledge, skills and abilities necessary to fulfill current or future job/role responsibilities effectively.

•

Presents information to individuals; conveys information clearly and concisely either verbally or in writing to ensure that listener understands the information and the message. Listens and responds appropriately to others.

•

Consistently ensures that projects within areas of responsibility are completed in a timely manner.

An individual must be able to perform each essential duty satisfactorily to perform this job successfully. The requirements listed above are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Competencies

Adaptability & Flexibility

Changes behavioral style or method of approach when necessary to achieve a goal; adjusts style as appropriate to the needs of the situation. Responds to change with a positive attitude and a willingness to learn new ways to accomplish work activities and objectives.

Attention to Detail

Thoroughness in accomplishing a task through concern for all the areas involved, no matter how small. Monitors and checks work or information and plans and organizes time and resources efficiently.

Professionalism

Thinks carefully about the likely effects on others of one's words, actions, appearance, and mode of behavior. Selects the words or actions most likely to have the desired effect on the individual or group in question. Maintains calmness in stressful or adverse situations. Diplomatically handles challenging or tense interpersonal situations.

Coaching & Mentoring

Works to improve and reinforce performance of others. Facilitates their skill development by providing clear, behaviorally specific performance feedback, and making or eliciting specific suggestions for improvement in a manner that builds confidence and maintains self-esteem.

Team Leadership

Willingly cooperates and works collaboratively toward solutions that generally benefit all involved parties; works cooperatively with others to accomplish organizational objectives. Manages staff in ways that improve their ability to succeed on the job.

Relationship Building

Builds constructive working relationships characterized by a high level of acceptance, cooperation, and mutual respect.

Integrity

Act with honesty, transparency and respect in our interactions with co-workers and those we serve. Adhere, without exception, to laws, policies, procedures and professional standards.

Accountability

Establish high-quality standards for work. Add value. Measure results and hold self and others accountable for making progress toward desired outcomes. Take a logical and data-driven approach to decision-making.

Diversity

Believe that different backgrounds and experiences strengthen the organization and produce better results. Value inclusion across race, gender, age, religion, identity and experience, and strive to reflect in our workforce the diversity of our community.

Collaboration

Foster a work culture in which different ideas and opinions are encouraged and expected. Listen carefully and speak thoughtfully. Work together toward shared goals with mutual respect and cooperation.

Continuous Improvement

Continuously improve work processes and products. Provide a safe environment to be innovative and creative and try new things. When things don't go as planned, use it as an opportunity to learn, regroup and begin again. Provide time and resources for individuals to grow and develop both personally and professionally.

Wellness

Take proactive steps to be physically fit and healthy, emotionally strong, financially secure and socially fulfilled, while inspiring and empowering others to do the same.

Service Orientation

Commit to making a difference within the community. Actively engage in and enjoy our work. Deliver services that exceed expectations, with courtesy, politeness and sensitivity to the experiences, concerns and feelings of all co-workers and customers.

ADA Checklist

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

Standard ADA Selection:

Office Environment

Standing

X

Walking

X

Sitting

X

Lifting/Carrying 0-10 pounds

X

Lifting/Carrying 10-20 pounds

X

Lifting/Carrying 20-50 pounds

X

Lifting/Carrying 50-100 pounds

X

Pushing

X

Pulling

X

Climbing

X

Balancing

X

Stooping

X

Kneeling

X

Crouching

X

Crawling

X

Reaching

X

Handling

X

Grasping

X

Fingering

X

Feeling

X

Talking

X

Hearing

X

Visual Perception

X

Repetitive Motions

X

Eye/Hand/Foot Coordination

X

Memorization/Concentration

X

Learning/Knowledge Retention

X

Preparing/Analyzing Numerical Figures

X

Use of Interfaced Commmunication Devices (Phone, Computer, Radio etc.)

X

Analyzing/Examining/Testing Data

X

Emotional/Behavioral Self-Regulation

X

Interacting with Others

X

Comprehension

X

Organization

X

Decision Making

X

Comprehension

Understand and apply routine verbal and/or written instructions

Organization

Organize and prioritize individual work schedule to manage multiple tasks and/or projects

Decision Making

Make decisions that have an impact on the immediate work unit's operations and/or services

Communication

Communicate and explain a variety of information

Extreme cold

X

Extreme heat

X

Humid

X

Wet

X

Noise

X

Hazards

X

Temperature Change

X

Atmospheric Conditions

X

Vibration

X

Computers/Monitors

X