DSHS HCLA Public Benefits Specialist 4

State of Washington•Multiple Locations Statewide, WA

2d•Remote

About The Position

Make a meaningful impact by helping Washingtonians access the long-term services and supports they need to live with dignity and independence. This statewide opportunity as a Public Benefits Specialist 4 with the Home & Community Services (HCS) division of the Home and Community Living Administration (HCLA) allows you to independently determine financial eligibility for complex long-term services and support programs that serve older adults and individuals with disabilities. In this position, you'll conduct detailed eligibility interviews, interpret federal and state regulations, analyze financial information, and collaborate with clients, caregivers, providers, and community partners to ensure eligible individuals receive the services and benefits they depend on. This role also supports Washington's 1115 Medicaid Transformation initiatives, including Medicaid Alternative Care (MAC) and Tailored Supports for Older Adults (TSOA) – innovative programs designed to delay institutional care by strengthening support for unpaid caregivers and older adults. Please note: these are project positions with an expected end date of June 30th, 2028.

Requirements

Advanced knowledge of federal and Washington State eligibility laws, regulations, and policies governing Medicaid, long-term services and supports, Basic Food, WASHCAP, and related public assistance programs.
Strong analytical and critical thinking skills with the ability to interpret complex financial information, legal documents, eligibility requirements, and policy guidance to make sound independent decisions.
Exceptional interviewing, communication, and customer service skills with the ability to effectively work with clients, families, attorneys, caregivers, interpreters, providers, and community partners.
Excellent organizational and time management skills with the ability to prioritize competing workloads, meet strict deadlines, and manage a complex caseload.
Ability to navigate multiple computer systems and databases while maintaining accurate documentation and protecting confidential client information.
Professional judgment, problem-solving, and conflict resolution skills, including the ability to de-escalate difficult situations and adapt to changing priorities.
Knowledge of community resources, partner agencies, and interdisciplinary collaboration to connect clients with appropriate programs, services, and supports.
A combination of five years in higher education and/or work experience in financial-based services, including at least one year of experience in areas such as: Reviewing or processing loan applications. Processing medical insurance or rehabilitation claims. Evaluating unemployment insurance claims. Assisting staff with financial eligibility determinations. Analyzing, verifying, or evaluating financial data.
Comparable experience from another state: Experience conducting financial eligibility determinations for public assistance programs (financial, medical, or food benefits).
A bachelor's degree or higher plus 12 months as a Public Benefits Specialist 2 (long-term care eligibility).

Responsibilities

Independently determine and maintain eligibility for complex long-term services and support programs, including Medicaid, Home and Community-Based Waiver Services, Community First Choice, nursing facility care, hospice, and other long-term care programs.
Conduct detailed interviews with clients, family members, guardians, attorneys, providers, and other representatives to evaluate financial and medical eligibility and determine client participation toward the cost of care.
Analyze income, resources, legal documents, trusts, property transfers, and other financial records while applying complex federal and state laws, regulations, and policies.
Process changes in client circumstances, resolve overpayments and underpayments, issue timely eligibility determinations, and ensure compliance with program requirements and established deadlines.
Serve as a subject matter expert by providing guidance to clients, caregivers, social workers, medical providers, community partners, and other stakeholders regarding long-term care eligibility and available resources.
Utilize multiple automated systems and databases to document case activity, verify information, maintain confidential records, and accurately process benefit determinations.
Coordinate with internal and external partners, including Social Security Administration, Veterans Affairs, Area Agencies on Aging, Adult Protective Services, and healthcare providers to support client access to services.
Protect client rights by ensuring equitable access to services, responding to audits and administrative hearings, making mandatory referrals when appropriate, and participating in ongoing training and professional development.