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Eligibility Case Manager
2 months ago
This position performs eligibility work that requires a strong working knowledge and understanding of eligibility program rules and policies and operation of the current prescribed eligibility computer program(s). The Eligibility Case Manager will perform duties associated with initial intake and ongoing eligibility determination for such programs as Food Assistance, Medical Programs, and Financial Assistance Programs as described in Colorado Staff Manuals, Volumes III, IVB, and VIII through the Department of Human Services or Department of Health Care Policy and Finance.
Key Responsibilities- Interprets rules and regulations of all program areas
- Screens applications to verify programs being applied for
- Conducts initial and ongoing program eligibility interviews and assessments by phone, face-to-face or during a home visit and gathers information such as income and financial resources
- Performs calculations and accounting functions necessary to establish eligibility and to determine the necessary steps to resolve client situations
- Facilitates and/or coordinates the processes and procedures necessary to provide clients with assistance
- Approves or denies applications, closes cases as necessary, and notifies clients of decisions in writing
- Completes required paperwork to restore benefits, provide retroactive payments, and provide supplements
- Transfers cases to the appropriate eligibility specialist, team, or closed caseload
- Assists clients in completing forms and obtaining the necessary documentation for program participation
- Assesses client needs and makes referrals to other agency and community services
- Uses computerized systems to research current and past assistance status and history
- Sets up new case files and properly categorizes household composition
- Maintains a working knowledge of the current eligibility computer system
- Performs data entry functions to ensure that required and relevant information is accurately entered into
- Ensures benefit calculations made by the current prescribed eligibility computer program(s) are accurate in order to reduce/eliminate errors
- Manages workload and paper flow
- Processes case changes as they occur
- Ensures that all case documents are filed in the electronic case file appropriately and in a timely manner
- Establishes and computes recoveries and restorations due as a result overpayment or underpayment; notifies fraud investigators when case information indicates that benefits may have been received based on fraudulent information
- Informs recipients/applicants of rules and regulations
- Explains rights and responsibilities to clients and provides referrals to non-profit agencies and other service providers to facilitate a comprehensive solution to the clients issues
- Maintains a working knowledge of program rules and regulations
- Receives, researches, resolves and clears information on required program reports
- Processes program sanctions
- Identifies the level and kind of sanction
- Provides sanction notification to the client being sanctioned
- Adheres to all County policies and procedures, and all laws and regulations as they pertain to assigned area
- High school diploma or equivalent and two (2) years office or public service experience required.
- Bachelors degree in public administration, behavioral sciences or appropriately related degree is recommended.
- Any combination of education, training and experience which provides the knowledge, skills and abilities required for the job may be substituted for the required education on a two for one-year basis.
- Minimum of one (1) year full-time professional case management and/or social casework
- Knowledge of case management principles and practices, concepts of self-sufficiency, welfare reform, and a general knowledge of the principles of human behavior.
- Knowledge of agency policies, eligibility laws, rules and regulations for public assistance program.
- A thorough knowledge of educational, training, employment and other resources available in the community.
- Diagnostic and interviewing skills.
- Skilled in writing, research, data management, and public contact/public relations.
- Ability to maintain a high level of professionalism.
- Ability to accurately and effectively transmit and receive information that is necessary to the accomplishment of goals and objectives including effective written and oral communication; ability to keep customers, subordinates, peers, and supervisors informed; and the ability to listen.
- Able to maintain courteous and effective working relationships with the public, County departments, co-workers and other agencies.
- Organization and time management skills.
- Computer proficiency required in word processing and databases.
The work environment characteristics described here are representative of those an employee encounters while performing essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Work is performed in an office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax/scan machines. Ability to tolerate and be productive in a quiet to moderate noise level in the work place. In addition, employees in this position will have frequent breaks in concentration caused by interruptions from staff or public and by phone. Employee will have periodic exposure to hazards in the field such as driving and inclement weather.
