Family & Children Medicaid - Eligibility Caseworker I

J  o  b    D  e  s  c  r  i  p  t  i  o  n

Job Information

Title:

Family & Children Medicaid - Eligibility Caseworker I

Market Range:

MR13

Approved Date:

2/19/2024 11:40:07 AM

FLSA:

Non-Exempt

EEO Code:

PROFESSIONALS

Career Level:

C2

Career Level Description:

Core Services Level 2

Job Code:

100364

Job Family:

Social Services

Sub Family:

Economic Services

Primary Purpose

Determines initial and ongoing eligibility for Family & Children Medicaid services administered by the county. Interacts extensively or minimally with the client- in person or on the phone in a fast-paced environment with tight deadlines.

•

Enters required data and documentation into NCFAST and other electronic systems to authorize benefits.

1

30%

•

Assesses information provided to determine initial and/or ongoing eligibility for assigned program(s).

2

20%

•

Responds to client inquiries, phone calls, emails, and requests for information; provides required notification of information needed and case outcome.

3

15%

•

Conducts interviews as required by program rules.

5

10%

•

Manages queues and workflows in OnBase, NCFast, and other systems as needed.

4

15%

•

Completes daysheets, timesheets, and case action forms.

6

10%

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

•

Attends staff meetings; participates in division and section workgroups.

•

Completes county and program trainings, both optional and required.

•

Logs hearing requests timely, completes hearing summaries, and attends hearings.

•

Performs other duties as required.

*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:

C2

Career Level Description:

Core Services Level 2

•

Works to deliver day-to-day objectives that moderately impact the achievement of the Work Group results.

•

Work typically involves regular review by senior employees and/or supervisors.

•

Responsible for making minor adjustments to work methods to solve problems that are routine and typically exist in current work processes and systems. May be required to highlight areas of concerns/problems and submit or recommend solutions to supervisor in own Work Group.

•

Communicates within and outside the Work Group to obtain or explain information.

•

May provide guidance and assistance to new or entry-level employees.

•

Requires basic job knowledge of systems and procedures obtained through prior work experience or education.

Qualifications

•

High school degree or GED

•

Two years of related experience

•

Valid Driver's License and "safe" driving record

•

Equivalent education and experience are accepted

•

1 Year

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)

Or

•

1 Year

Experience in a Human Services Technician role supporting any Human Services program in a county or state Department of Human Services or Social Services agency

Or

•

1 Year

Experience determining eligibility for a Financial or Insurance Provider for financial assistance or insurance claims

Or

•

1 Year

Experience assessing the financial capabilities and need for financial assistance (e.g. Financial Counseling)

Or

•

1 Year

Direct clerical or customer services experience providing support to a Medicaid, Food and Nutrition Services, Work First, or Child Care Subsidy Program within a State or County Department of Social Services

Or

•

1 Year

Experience working with the homeless population

Or

•

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.

•

Ability to apply complex policy to determine client budgets and proficient in calculating client budgets.

•

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

•

Ability to review and assess financial information.

•

Spanish proficiency- verbal and written.

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.

Customer Service

Balances interests of a variety of clients, and readily readjusts priorities to respond effectively to pressing and changing demands for information, advice and assistance.  Anticipates and meets the needs of clients; achieves quality end products; and commits to continuous improvement of services.

Interpersonal Skills

Treats others with courtesy, sensitivity, and respect.  Considers and responds appropriately to the needs and feelings of different people in different situations.  Perceives, assesses, and positively influences one's own and other individuals’ emotions.

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.

Reliability

Demonstrates a high level of dependability in all aspects of the job.

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 non-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 individual's work

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