INCOME MAINTENANCE CASEWORKER III - (ADULT MEDICAID)

Durham County•Durham, NC

3d•$49,262 - $66,474•Hybrid

About The Position

Employees in this class are responsible for serving in maintenance roles in a County Department of Social Services. The income maintenance programs involved include Food Stamps, Aid to Families with Dependent Children (AFDC), Medicaid and County Special Assistance. Employees serve in one of the following roles: (1) As lead worker over II level income maintenance caseworkers or as lead worker over a unit of a single program area which performs all functions (i.e., intake, processing, and review). Work may also include performing the same eligibility determination functions as the Income Maintenance Caseworker I and/or II. Employees are required to spend at least 25 percent of their time in a lead worker capacity. (2) Performing a wide range of tasks in the eligibility determination/re determination process which require an in-depth knowledge of all income maintenance programs and functional processes. Work also involves the resolving of client appeals of actions taken by income maintenance caseworkers, the analysis of program-wide problem areas which include recommendations for corrective action and the training of new and transitional employees for specialized programs (i.e., LIEAP). (3) Functioning with a great deal of independence in a hospital or medical setting with the responsibility for performing a variety of complex tasks and functions in the Medicaid programs which include performing two or more functions in the long-term care programs. Employees assume responsibility for the resolution of complex problems where the consequence of their action can have a considerable effect on the client, the medical institution and/or the agency. Employees are viewed by the medical institution's administrative staff as the primary contact for problem resolution. Employees usually report to a higher level supervisor and review of work at this level is minimal. The primary purpose of this position is to take and process Adult Medicaid applications for Durham County residents. The Incumbent will work with clients by gathering information through an interview process for the purpose of determining applicant/client eligibility. In addition, they will also inform the client of their rights and obligations as prescribed under program policies. Applications taken and processed or assigned to and processed by this position are randomly selected, pulled and checked for accuracy and timelines by the Supervisor/Lead Worker and state personnel. The Incumbent prepares and presents the summary of the agency’s evidence for any local or state appeal hearing resulting from case actions taken by this position. The incumbent may be assigned other duties in the other program work areas as needed.

Requirements

Considerable knowledge of NC FAST and Social Service programs specifically Adult Medicaid
Ability to read, analyze, and interpret rules, regulations and procedures.
Ability to research, analyze and interpret automated system problems
Ability to communicate with clients/applicants, the public at large, and public officials to obtain data, and to explain and interpret rules, regulations and procedures.
Ability to perform caseworker functions within structured time frames.
Ability to work under pressure and handle multiple tasks are essential
Thorough knowledge of income maintenance program assigned (i.e.- medicaid).
Considerable knowledge of all agency and community programs and services which could affect the client/applicant.
General knowledge of all income maintenance programs.
Good mathematical reasoning and computational skills.
Ability to read, analyze, and interpret a variety of regulations, policies and procedure of varying complexity.
Ability to work independently and prioritize work.
Ability to instruct arid evaluate the work of lower level employees.
Ability to train employees in new and existing rules, regulations, policies and procedures.
Two years of experience as an Income Maintenance Caseworker; or an equivalent combination of training and experience.

Nice To Haves

Three years or more of direct experience working in Adult Medicaid in local or State Department of Social Services.
Direct Adult Medicald experience.
A degree from an accredited college or university.
An associates degree in accounting, business administration, human services, secretarial science or closely related field and at least two years of paraprofessional, clerical or other public contact experience which includes negotiating, interviewing, obtaining, analyzing and/or evaluating data.
A high school diploma and at least five years of paraprofessional, clerical or other public contact experience which includes negotiating, interviewing, obtaining, analyzing and/or evaluating data.

Responsibilities

As lead worker over II level income maintenance caseworkers, employees must be thoroughly familiar with all functional aspects required to properly process the applications of clients applying for benefits.
Employees must be knowledgeable enough to advise and counsel lower level staff on policies and regulations of the income maintenance program(s) which affect the more complex cases.
Work also requires the provision of training to lower level staff in new program policy directives as well as the completion of second party reviews in the work unit assigned.
As a troubleshooter in a large agency, employees' work is characterized by the level of program and procedural knowledge required to work effectively in any line staff position assigned, which includes all income maintenance programs and all functions.
Employees act as a hearing officer in resolving client appeals of action taken by income maintenance workers and must be proficient in the analysis of program wide problem areas which include recommendations for corrective action.
Work also includes providing training for new and transitional employees.
As a hospital/medical setting worker, employees are responsible for determining and/or re-determining client eligibility for the Medicaid programs with particular expertise in the Medicaid long-term care programs.
Work also requires the taking and/or processing of client applications for all other income maintenance programs and the provision of technical expertise to hospital administrators and professional staff on issues impacting upon client eligibility for medical assistance as provided by the Medicaid programs).
Take and process Adult Medicaid applications for Durham County residents.
Work with clients by gathering information through an interview process for the purpose of determining applicant/client eligibility.
Inform the client of their rights and obligations as prescribed under program policies.
Prepare and present the summary of the agency’s evidence for any local or state appeal hearing resulting from case actions taken by this position.
May be assigned other duties in the other program work areas as needed.