Eligibility Specialist II - LTC
About The Position
The Department of Health and Human Services (DHHS) is seeking an Eligibility Specialist II for the Long-Term Care (LTC) Eligibility Unit. This role focuses on MaineCare policy and involves determining initial and continued eligibility for public assistance programs. The position may also include quality control work, reviewing eligibility decisions made by others. It operates in a fast-paced environment with high standards for customer service and program accuracy. The specialist will gather sensitive and personal information to make timely and accurate eligibility determinations, requiring strong interpersonal and conflict resolution skills to interact with diverse individuals, potentially in various emotional states.
Requirements
- A four (4) year combination of education, training, and/or progressively responsible experience in a social services setting which demonstrates interviewing and data gathering skills as needed to form basis for judgments in eligibility determinations, claims resolutions, and/or customer service requests
- OR a Bachelors Degree in Social Services, Business Administration, or other related field
- Strong interpersonal and conflict resolution skills
- Ability to work in a fast-paced environment with high standards for customer service and program accuracy.
Nice To Haves
- Lived experience and passion that sets you apart.
Responsibilities
- Determine initial and continued eligibility for public assistance programs, with a focus on MaineCare policy.
- Perform quality control work by reviewing eligibility decisions made by others.
- Gather sensitive and personal information to make timely and accurate eligibility determinations.
- Interview clients, obtain and assess all necessary facts, data, supporting information, and documentation pertaining to the application or recertification for public assistance.
- Evaluate information and apply allowable standards and criteria.
- Explain program eligibility requirements, rules, regulations and individual rights and responsibilities to clients and their representatives.
- Review and analyze information for accuracy; identify inconsistencies; request necessary documentation; verify and validate data.
- Answer inquiries and refer clients to various programs.
- Accurately enter data into an automated system and ensure accurate eligibility results.
- Communicate verbally and in writing with clients, co-workers and other agencies.
- Perform intermediate mathematical calculations.
- Maintain confidentiality of all applicant and recipient information.
Benefits
- 13 paid holidays
- 12 days of sick leave
- 3+ weeks of vacation leave annually
- Health Insurance Coverage (State pays 85%-100% of employee-only premiums)
- Health Insurance Premium Credit (Participation decreases employee-only premiums by 5%)
- Dental Insurance (State pays 100% of employee-only dental premiums)
- Retirement Plan (State contributes 14.11% of employee's pay towards MainePERS)
- Six weeks of fully paid parental leave for all employees welcoming a child (including non-birthing and adoptive parents)
- Additional, unpaid leave may also be available under the Family and Medical Leave Act.
- Extensive and highly competitive benefits package covering many aspects of wellness.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
