Adult Medicaid Long Term Care - Eligibility Caseworker III

What You'll Be Doing

The Wake County Social Service’s Economic Self‑Sufficiency division has over 225 Eligibility Caseworkers who provide critical resources for the citizens of Wake County. Eligibility Caseworkers determine eligibility based on factors such as income, family size, medical information, medical evaluations/ health conditions, resources, deductible expenses, and needs. Applications are processed in NCFAST (the electronic case management system) and OnBase (the document management system) to issue benefits and perform case management functions.

The Eligibility Caseworkers spend the majority of time within NCFAST and OnBase to determine clients’ eligibility.

We are currently seeking an Adult Medicaid Long Term Care - Eligibility Caseworker III to join our Economic Self‑Sufficiency team.

• Providing case management service by determining on-going eligibility for Long Term Care and Special Assistance and/or Community Alternative Program for Children (CAP‑C)
• Entering all required data into computer systems in order to authorize benefits
• If needed, refer household to outside community resources
• Maintaining thorough knowledge of all policy and procedures by attending training and keeping abreast of all policy changes
• Providing back up to other Case Managers
• Providing accurate and timely documentation, utilize document management system for caseload management
• Determining eligibility for a State or County Department of Social Services program (Medicaid, Adult Medicaid, Long Term Care, Special Assistance & CAP‑C)
• Actively supports and participates in department emergency preparedness and response activities, which may include temporary changes in responsibilities and working hours. In the event of an emergency, as determined by the County Manager or designee, participation in preparedness and response operations should be expected. Employee may be required to fill a temporary assignment in a role different from standard duties, work hours and/or work location in preparation for, during and after the emergency.
  
  Employee may also be required to participate in relevant exercises and regular preparedness training.

The Wake County Department of Social Services team is grounded in a deep commitment to connection, compassion, and community. We bring together experienced professionals who collaborate to support individuals and families through complex challenges, connect them with critical resources, and promote long-term stability. We value insight, innovation, and a solutions‑focused approach, and we welcome those who are ready to contribute their expertise to meaningful, community‑centered work.

Join us in making a lasting difference!

• Associate's degree in Human Services or a related field
• Two years of job‑related experience
• Equivalent education and experience are accepted

• Please include ALL prior work experience on your application and resume.

• Two years of experience determining eligibility in Adult Medicaid, Long Term Care, Special Assistance
• NCFast knowledge

• Ability to determine eligibility for Medicaid, Adult Medicaid, Long Term Care, Special Assistance
• Ability to identify issues, obtain relevant information, relate and compare data from different sources, and identify alternative solutions
• Knowledge and strong understanding of Adult Medicaid policy
• Ability to interpret new and changed policies
• Ability to develop and maintain strong relationships with clients by listening to the clients and understanding and responding to identified needs
• Ability to explain Medicaid policy, in layman's terms for beneficiaries, family members, and facility representatives can understand
• Excellent organizational skills and ability to maximize the use of time so that the many diverse tasks associated with the position can be completed in a timely manner
• Ability to accomplish tasks and processes accurately and completely

Location:

HSC Swinburne Raleigh, NC 27610

Employment Type:

Regular

Work Schedule:

Mon.

- Fri. 8:30 am - 5:15 pm, hybrid

Hiring Range:…