Supervising Eligibility Technician

Supervising Eligibility Technician

To plan, assign, supervise and review the work of a staff engaged in performing eligibility determinations, both initial and continuing, for individuals applying for or receiving assistance payments; to perform complex eligibility determination evaluations; and to do related work as required.

Works under the general direction of a superior with wide latitude for the exercise of initiative and independent judgement; work is subject to review upon completion for conformance to established standards, rules and general policy.

Plans, assigns, supervises and reviews the work of a technical and clerical staff.

To plan, assign, supervise and review the work of a staff engaged in: performing eligibility determinations, both initial and continuing, for individuals applying for or receiving assistance payments; assisting applicants/recipients in filling out applications/providing supporting evidence; referring to service personnel those applicants/recipients who express a need for service oriented functions; providing information to applicants/recipients and the public in general concerning eligibility requirements for various assistance programs;

conducting in-person interviews - both in office and field; and other eligibility related functions.

To perform complex eligibility determinations, both initial and continuing, for individuals applying for or receiving assistance payments where several program areas are involved.

To refer to service personnel those applicants/recipients whose situation indicates a need for service oriented functions.

To collect data and prepare reoccurring and special reports, including simple statistical breakdowns.

To do related work as required.

A thorough knowledge of federal and state law and regulations concerning initial and continuing eligibility requirements for assistance payments; a thorough knowledge of departmental policy concerning the conducting of interviews and the ability to conduct complete and thorough information gathering interviews; a working knowledge of assistance programs; the ability to provide information and deal with applicants/recipients and the public in general in a tactful and courteous manner;

the ability to supervise a staff of technical and clerical workers; the ability to follow written instructions and to complete eligibility related forms and applications; the ability to prepare and submit special and reoccurring reports including statistical breakdowns; the ability to recognize specific information from a mass of data; and related capacities and abilities.

Education:

Such as may have been gained through: successful completion of at least two years of academic study in an accredited institution of higher learning; and

Experience:

Such as may have been gained through: full-time employment in a responsible position which required the making of evaluations and important decisions based on a review of information gained through interviews, applications or completed records.

Or, any combination of education and experience that shall be substantially equivalent to the above education and experience.

This position will be known as the Program Integrity Review Specialist and report to Program Integrity Unit. Conducts case reviews across all DHS Programs using a variety of review tools and processes. Conduct both pre-authorizations and post-authorization case reviews based on established review requirements and priorities. Reviews cases across programs, including Supplemental Nutritional Assistance Program, Medicaid, Child Care Assistance Program, Rhode Island Works Program, and other DHS Programs as assigned.

Identifies case processing errors, trends, and opportunities for improvement through review of case record, eligibility determination, and supporting information. Applies program knowledge, policy and procedural knowledge and review standards to evaluate the accuracy and quality of case actions and eligibility determinations. Documents review findings accurately and timely; to support data analysis, corrective action, and program improvement. Provides feedback on case findings and recurring issues to support the Program Integrity feedback loop.

Participates in quality control, quality assurance, state and federal review activities as assigned. Remains flexible in assignments and develops proficiency with multiple review tools, programs, and review methods. Collaborates to develop materials and field guidance related to error trends.