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Eligibility Specialist III at CalHR

CalHR Red Bluff, CA

Job Description

Position InformationThe Eligibility Specialist III is the advanced journey/lead-level classification and subject matter expert in the Eligibility Specialist series. Incumbents perform the most complex work and specialized assignments requiring an advanced level of technical knowledge in public assistance programs departmental processes and caseload/workload administration. Incumbents are expected to independently perform specialized and/or complex duties beyond the journey-level classification of the addition incumbents may perform help desk functions provide training to a unit of workers determining eligibility for public assistance and/or serve as a lead worker for less experienced employees. Incumbents demonstrate advanced knowledge of eligibility regulations procedures and eligibility software systems. Other assignments may include performing quality control and/or quality assurance reviews participating in early fraud prevention programs representing the County in administrative appeals and fair hearings and/or performing other specialized assignments and related work as required.The Eligibility Specialist III differs from the Eligibility Supervisor in that the latter directly supervises a unit of Eligibility Specialists. The class of Eligibility Specialist III is distinguished from the Eligibility Specialist II as the latter requires a higher level of supervision and the Eligibility Specialist III is assigned lead specialist duties or special assignments with a greater degree of independent judgment.Typical duties of an Eligibility Specialist III include: Providing lead direction and/or training to a unit of workers determining eligibility of applicants; assisting in the development and implementation of procedures; providing services to drop-in clients performing local help desk functions completing specialized assignments in areas of investigations quality assurance and control and fair hearings; explaining regulations rules and policies to clients and apprising them of their rights and responsibilities and eligibility for participation; organizing and prioritizing caseload/workload so that necessary case records and documents are processed and updated within specific time limits; troubleshooting tasks and/or case issues to determine appropriate resolution of problems; responding to questions and complaints of clients in person by telephone mail and/or email communication; participating in special projects studies work assignments meetings conferences and committees.Controversial Issues:As an Eligibility Specialist you may be required to take actions that conflict with your own values. An Eligibility Specialist must be able to accept customers differences and interact with them in a non-judgmental manner.Ideal Candidate: The ideal candidate for this position will have a strong emphasis on continuous quality improvement; strong work ethic and ability to prioritize assigned work tasks and follow through in a timely manner; skills necessary to lead direct and train other eligibility staff; excellent listening and strong written and verbal communication skills; exceptional customer service skills and initiative; solution based problem solving skills; experience in maintaining cooperative relations and communications with customers management and staff; ability to maintain a high standard of professionalism; proficiency in Microsoft Office as well as basic knowledge of software and database programs.SUPERVISION EXERCISED AND RECEIVEDIncumbents in the Eligibility Specialist III classification receive supervision from an Eligibility Supervisor or other manager. An Eligibility Specialist III has no responsibility for direct supervision of others but may provide lead direction to other Eligibility Specialists.Examples of Duties Provides lead direction and/or training to a unit of workers determining eligibility of applicants and recipients for public assistance programsProvides support to supervisor with unit operations and coveragePerforms interactive interviews to elicit eligibility information obtain and/or verify financial employment tax and personal demographic information and identify need for public assistance programs and servicesAssists in the development and implementation of procedures for public assistance programsAnalyzes financial and eligibility information to determine initial or continuing eligibility for multiple aid programsMay provide services to drop-in clients perform local help desk functions provide lead direction and training to unit staff and assist with the more complicated cases or perform specialized assignments in the areas of investigations quality assurance and control and fair hearingsExplains regulations rules and policies to clients and apprises them of their rights responsibilities and eligibility for participationEnsures accuracy and completion of application and declaration formsResolves discrepancies by securing documentation medical records and confirmation from other agenciesEnters and retrieves numerical and narrative data and issues benefits from an automated computer systemDetermines the level of benefits to which the client is entitled by making complex mathematical computations and/or complex computer entriesReviews and interprets information provided on a variety of forms both by the client and third parties to assist with eligibility determinationEvaluates clients for and answers questions on Advanced Payment Tax Credits (APTC) related to health care reformExplains a variety of plan options costs and individual plan features through Covered CaliforniaMonitors on-going eligibility by obtaining periodic updated information of eligibility factors and takes appropriate actions on changesDetermines need for additional services and makes referrals as needed for employment and other services to outside agencies to assist clients toward self-sufficiency and directs clients accordinglyOrganizes and prioritizes caseload/workload so that necessary case records and documents are processed and updated within specific time limits established by regulation and local policyCompletes and maintains case records including written narratives forms and computer documents in a clear and readable formatTroubleshoots task and/or case issues to determine appropriate resolution of problems involving Help Desk as needed; may participate in system testing and designCommunicates both orally and in writing with clients and others related to the initial and ongoing eligibility determination while maintaining confidentialityResponds to questions and complaints of clients in person by telephone mail and/or email communicationProvides pertinent forms and pamphlets to clients as requiredIdentifies suspected fraud and makes referrals for investigationMakes referrals to social service workers as neededParticipates in special projects studies work assignments meetings conferences and committeesPrepares correspondence and reportsPerforms related duties as assignedEMPLOYMENT STANDARDSKnowledge of: General goals and purpose of public social services programsLaws rules regulations policies and procedures governing eligibility for diverse public assistance programs and related case administrative techniquesMethods and techniques of conducting an investigative interview and information gatheringComputer terminology and computer keyboard arrangementPrinciples of training and staff developmentModern office practices methods and proceduresRecord keeping practices and proceduresPrinciples of mathematical calculationsIntricacies of health insurance plans and medical health plan options and associated terminologyRegulations and rules regarding household filing status related to the Affordable Care ActCultural and human behavior including knowledge of self to interact effectively with clients and staffPrinciples and practices of effective customer serviceStructure and content of the English language including the meaning and spelling of words rules of composition and grammarModern equipment and communication tools used for business functions and program project and task coordinationComputers and software programs (e.g. Microsoft software applications) to conduct research assess information and/or prepare documentationAbility to: Lead direct and train other eligibility staffEvaluate and make appropriate recommendations and corrections on selected casesDetermine appropriate course of action in emergency situationsApply the laws rules and regulations governing eligibility and grant determination for multiple public assistance programs and the case administration of these programsIdentify available resources and communicate with others to obtain and verify information concerning eligibilityUse fact finding techniques and perform in-depth and interactive interviewingMake referrals to appropriate agencies and social service programsDetect and evaluate potential fraudulent situationsAnalyze and interpret written numerical and verbal data from various sourcesUtilize multiple electronic information social services systems and analyze and interpret such informationEnter data accurately into a computerized systemNavigate through computer screens and effectively use computer systems software applications and modern business equipment to perform a variety of work tasksIdentify when computer output is incorrect and make correctionsProcess cases manually as requiredPlan and organize caseload/workload to ensure work is completed in accordance with regulations relating to eligibility and timelinessFunction effectively in a system with strict deadlines and constant changesRead understand apply and explain complicated and detailed correspondence and reports regulations and policy directivesPerform a variety of mathematical computations accurately and rapidlyPrepare clear concise and accurate records and reportsExplain complex rules and programs so they can be understood by people of diverse socio-economic cultural and educational backgroundsGather record and correctly evaluate IRS tax filing data income and additional necessary information required for the determination of eligibility for one or more programsExplain health insurance plan options and plan details available to clients through the Affordable Care ActReview a variety of tax documents to obtain needed household filing informationExplain health care reform tax credit implications to clientsRefer clients to other community services as neededAssess and manage difficult and hostile persons or situations; or call for intervention when appropriateInteract with people in a courteous manner both in person on the telephone by mail or email communicationWork in a fast-paced professional office environment and prioritize a wide range of duties with varying time requirements to ensure timely completionCommunicate clearly and concisely both orally and in writing using appropriate English grammar and syntaxEstablish and maintain cooperative working relationships with the public and staffFollow written and oral directions and instructionsMinimum QualificationsOne (1) year full time experience in an Eligibility Specialist II classification in an Interagency Merit System (IMS) County;ORThree (3) years of full time experience determining eligibility for public assistance programs in a public human services agency.Supplemental InformationEXAMINATION INFORMATIONTRAINING & EXPERIENCE EXAMINATION WEIGHTED 100% The Training & Experience Examination is designed to elicit a range of specific information regarding each candidates knowledge skill abilities and potential to effectively perform the duties relative to the classification. Responses to the questionnaire will be assessed based on pre-determined rating criteria. All applicants must complete the entire examination to receive a order to obtain a position on the eligible list candidates must receive a minimum rating of 70% on the examination. MSS is accepting applications on a continuous basis. Qualifying candidates will be notified via email with instructions for completing the examination within 30 days of the date of application.ELIGIBLE LIST INFORMATIONA departmental open eligible list will be established for the county of Modoc. The list will be utilized for 12 months after it is established unless the needs of the service and conditions of the list warrant a change in this period.RETEST PERIODOnce you have taken the examination you may not retest for SIX (6) MONTHS from the established eligibility date.SPECIAL TEST ARRANGEMENTSSpecial testing arrangements may be made to accommodate applicants for disability military or religious reasons. If you require such arrangements please contact CalHR at or upon notification that your application has been approved. Documentation from medical military school or church officials outlining the accommodation request must be received by our office a minimum of five business days prior to a scheduled examination.EDUCATION DOCUMENTSIf you are using education to meet the minimum qualifications you must attach your transcripts to your application. Applicants with foreign transcripts must provide a transcript evaluation that indicates the number of units to which the foreign course work is equivalent. Transcripts and evaluations may be unofficial; official transcripts may be required upon appointment. Please redact birthdates and social security numbers.GENERAL INFORMATIONThis position is not eligible for visa sponsorship. Applicants must be authorized to work in the United States without the need for visa sponsorship by the start date of employment.MSS reserves the right to revise the examination plan to better meet the needs of the recruitment if the circumstances under which this examination was planned change. Such revision will be in accordance with civil service laws and rules and all competitors will be notified. If you meet the requirements stated on this bulletin you may take this examination. Your performance in this examination will be rated against predetermined rating criteria. All competitors who pass will be added to the eligible list. Meeting the entry requirements does not assure success in the examination or placement on the eligible list. General Qualifications: Applicants must possess essential personal qualifications including integrity initiative dependability good judgement the ability to work cooperatively with others and a state of health consistent with the ability to perform the assigned duties of the class. A medical examination may be required. As part of the hiring process a background investigation may be required.EQUAL EMPLOYMENT OPPORTUNITYThe Merit System Services program is committed to equal employment opportunity for all regardless of age ancestry color disability (mental and physical) exercising the right to family care and medical leave gender gender expression gender identity genetic information marital status medical condition military or veteran status national origin political affiliation race religious creed sex (includes pregnancy childbirth breastfeeding and related medical conditions) and sexual orientation.Benefits This position offers the following benefits:Represented by the Joint Council bargaining unit.96 hours of vacation per year increasing upon continuous years of service.96 hours of sick leave per year.14 paid holidays plus one 8-hour personal holiday.CalPERS retirement plan 8% employee contribution.The County pays approximately 80% of premium for medical dental and vision plan (including a $30000 life insurance plan for employee). For the employee and entire family the current employees share of the insurance plan is $234.54 per month.Annual salary step increase based upon satisfactory performance and completion of 2080 hours (Steps A to E).Deferred compensation plan with the County matching the employees deposit up to $60 per month.Supplemental insurance plans are available.Employee Assistance Program is provided to all employees at no cost by the County.Additional InformationADA/EEO/DRUG-FREE WORKPLACEAs a condition of employment Tehama County Social Services will require:A valid drivers license will be required at the time of appointment. Individuals who do not meet this requirement due to a disability will be reviewed on a case-by-case basis.Proof of ability to work in the United StatesPre-employment drug testing and physicalGovernment agencies accessing US government information which include federal tax information must ensure that background investigation requirements for all agency employees and contractors that have access to federal tax information are consistent to the IRS background investigation requirements for access to federal tax information. A background check may be required if the position requires access to these types of records. Background requirements consist of three components which include fingerprinting citizenship verification and local law enforcement checks. State agencies must conduct investigation during time of hire and ensure a reinvestigation is conducted 10 years from the date of the previous background investigation for each employee that has access to federal tax information.About Tehama CountyBeautiful Tehama County is in the heart of northern California midway between Sacramento and the Oregon border. Based on the shores of the Sacramento River and in the shadows of Mount Lassen Tehama County boasts some of the lowest housing costs in California along with short commute times to work. The County is home to a myriad of recreational activities.Required Experience:IC Key Skills Sales Experience,Crane,Customer Service,Communication skills,Heavy Equipment Operation,Microsoft Word,Case Management,OSHA,Team Management,Catheterization,Microsoft Outlook Calendar,EHS Employment Type : Full-Time Experience: years Vacancy: 1 Hourly Salary Salary: 23 - 28

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