Lead Eligibility Case Manager – Douglas County

Title of the Job: Lead Eligibility Case Manager

Location: Castle Rock, CO

Job Description: Lead Eligibility Case ManagerEmployment Type: 0 – Full-time Regular
Pay Range: $55,364.00 – 83,046.00
Location: Castle Rock, Lone Tree, or Highlands Ranch, CO
Overtime Exempt: N
Elected Office / Department: HUMAN SERVICESProvides lead level accountability for other employees within work unit which may include scheduling, assigning, and reviewing work, instructing/training in work methods, and providing input into hiring and performance evaluation processes. Position provides a variety of technical functions and expertise in the unit, including but not limited to, technical expertise to staff, Supervisor and Manager, training, and provides requested assistance to the Supervisor and Manager. Position may be responsible to manage a caseload. Position uses State and County-based computer systems as required by the job. Oversees daily activities in the unit in the absence of the Supervisor or Manager, or as assigned.Generally, the hiring range is $55,364-$69,205 annually. Qualifications, education and experience as it relates to the position will be taken into consideration when determining hiring salary.Douglas County offers an excellent comprehensive benefit package including but not limited to: Medical/Dental/Vision/Retirement. For a more detailed overview please view the full .ESSENTIAL DUTIES AND RESPONSIBILITIES: (The following examples are illustrative only and are not intended to be all inclusive.)

• Performs support, guidance, and oversight of daily responsibilities to Eligibility Specialists.
• Trains staff through individual and group settings to acquire skills and knowledge for specific functions and/or programs.
• Acts as a Colorado Benefit Management System (CBMS) resident expert.
• Participate in county and state level meetings and conference calls as needed, submit and monitor help desk tickets, and ensure all unit staff are advised of issues and solutions.
• Provides client support by being the first level contact for customer complaints and concerns including calls, and written complaints.
• Supports the Department with the coordination, performance, and follow-up of any Federal, State, County, or Department audits/reviews.
• Perform staff case reviews to ensure case accuracy and worker productivity.
• Provides technical expertise to management and staff with respect to legislation, rules, regulations, data management and interpretation, quality assurance functions, case management strategies, computer systems, and other work-related tasks.
• Prepares written correspondence for county or state level dispute resolution processes or hearings. Prepares case information required for testimony and serves as representative at county and state evidentiary hearings or appeals; testifies as necessary.
• May generate reports/compile data for the Supervisor, Manager or Director.
• Understands indicators and types of client, provider and employee fraud.
• Able to make the distinction between claims, program violations and fraud. Exercises excellent judgment and knowledge about how to proceed with initial research and follow-up, and when to make a referral to investigations. Acts as a resource in relation to establishment of overpayment claims, providing technical guidance to staff seeking
• clarification and understanding. Provides individualized support to specialist and clients when a claim is generated; provides answers to claims questions.
• Maintains a caseload of complex, confidential, and/or sensitive clients and complete all work related to that caseload, including:
• Make eligibility determinations for applications, redeterminations, and changes and informs applicants of results within the appropriate time frame and in a manner that can be understood by the client.
• Interfaces daily with statewide computer system requiring accurate and complete data entry of information. Maintains client records within electronic content management system and the CBMS program.
• Provides information and assesses need for referral to other Department staff and other community agencies.
• Utilizes computer daily for data entry and inquiry, for preparation of complex correspondence and spreadsheet development, and for records research and maintenance.
• Accomplish assigned workload and tasks in a timely manner and meet established performance standards and objectives.
• Contributes to the preparation of staff evaluations by providing the Supervisor information, feedback, and data on daily performance and other general observations. Notifies the Supervisor, Manager, or any appropriate party of employee performance and/or fraud concerns.
• May serve in an advisory capacity in cooperation with management; may facilitate team meetings, arrange staff and/or program coverage, manage customer service issues, approve exceptions to policy, manage programmatic issues, and provide other work-related assistance to staff in lieu of management.
• Performs other duties as assigned.

SUPERVISION RECEIVED: Perform duties independently without close supervision.SUPERVISORY RESPONSIBILITIES: Oversees daily staff work. Does not have authority to execute Human Resource functions. Advises Supervisor on staff performance and areas for improvement.INDEPENDENT JUDGMENT: Must exercise judgment in applying rules and regulations and ensure that all information is accurate and verified as required by Federal, State and County rule and policy, as well as based on objective review of the facts. Consequence of error may result in providing inaccurate information to Division or Department Management, eligibility staff and the public. Errors in benefit determination could impact reimbursements to the County, negatively affect client benefits, and result in the initiation of client recoveries and County and/or State repayments and adverse audit findings.MINIMUM QUALIFICATIONS:EDUCATION and/or EXPERIENCE:

• A high school diploma or GED is required. Associate or Bachelor degree preferred.
• Must have a minimum of three (3) years experience determining eligibility for Supplemental Nutrition Assistance Program (SNAP), Medicaid, Temporary Assistance to Needy Families (TANF), Old Age Pension (OAP), or Aid to the Needy Disabled (AND).
• Experience using the Colorado Benefit Management System (CBMS) to determine eligibility for the above programs, is preferred.
• Experience with preparing cases for appeal and/or investigations preferred.
• A combination of education and experience may be considered.

KNOWLEDGE, SKILLS, AND ABILITIES:Knowledge:

• Work is primarily directed through state regulations and procedures. Incumbent must be knowledgeable of rules and regulations and be able to interpret those rules and regulations as they relate to the applicant/client.
• Principles and concepts of human behavior.

Skills:

• Provide professional customer service to clients and public.
• Ability to interview clients while inputting data into a computer.
• Perform basic mathematical calculations including percentages.
• Use of routine software and business applications including, but not limited to, word processing, spreadsheets, presentation software, and databases and ability to learn and utilize CBMS and other state computer-based systems.
• Excellent communication skills both written and verbal.
• Strong organizational skills and attention to detail.
• Analytical and problem-solving skills.
• Spanish language skills a plus.

Abilities:

• Effectively respond to conflict situations and people in crisis.
• Ability to prioritize workload and complete work in a timely manner, despite deadlines, high volume of work and interruptions.
• Ability to work independently and as a team member.
• Able to mentor, effectively sharing expertise with less-experienced coworkers.
• Ability to solve problems and develop solutions.
• Ability to adapt in a fast-changing work environment.
• Ability to apply common sense understanding and critical thinking to the situations presented.
• Ability to read, interpret and apply legislation, statute, regulation, and policies.
• Ability to develop reports and correspondence.

CERTIFICATIONS, LICENSES, & REGISTRATIONS:

• Have and maintain Colorado Benefits Management Systems (CBMS) certification. Individuals hired without certification are expected to complete Colorado Benefits Management Systems (CBMS) Training within three (3) months of hire.
• Individuals hired are also expected to have and maintain program-specific training such as MAGI Medicaid, Non-MAGI Medicaid, Long-Term Care, SNAP, Colorado Works, and Adult Financial.
• This position requires successful completion of a criminal background check including fingerprinting through a national database.

WORK ENVIRONMENT: Work is generally performed in a typical office environment. This position may be eligible for hybrid work setting; partially remote and partially office based. Requires direct and regular contact with the public. Work tools include computer, fax machine, desk phone and cellular phone, iPad or similar device, and other typical office equipment. Must be able to read, write, hear, and speak clearly. Office location within Douglas County may vary based on department needs.ADDITIONAL INFORMATION:Closing Date: 12/13/2024 5:59PM MST. Review of applications will begin immediately and continue until a suitable candidate is selected.The job details outlined in this posting may represent a modified summary of the full job description. For a full copy of the job description to view our job classifications.In the event of an emergency/disaster in or near the County, all County employees are expected to make every effort to be available to assist the County Manager, Elected/Appointed Officials and Department Directors to ensure the continued operation of any and all necessary County functions. This may mean being available to perform additional duties and hours beyond what is normally required. In the event that an exempt employee does work more than 40 hours a week in support of County operations during an emergency, such employee may receive overtime or other appropriate wage compensation in accordance with existing County policies or at the discretion of the County.

Company Name: Douglas County

Salary: $55364 – 83046 per year

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