Government Program Eligibility Specialist I

Job Code: 32001221
Salary Grade: NC05
Revision Date: 06/2018

Class Concept

Positions in this classification work within government benefits programs. Positions usually provide consultation and program eligibility determination within a large, complex, government benefits program. Positions may serve as lead consultant, and/or program unit supervisor program manager. Work involves and assessing client information against a variety of complex state and federal laws and guideline, investigating non-standard issues that affect client benefits eligibility, and responding to client questions. Positions interpret and apply program policies and practices. Positions provide consultation and counseling; perform program/project administration and conduct information research and analysis. Work may include marketing the program to constituent groups. In these roles, employees may supervise staff. Work is often performed independently and positions may be out-stationed from the central or local branch office.

These positions will advise and collaborate with clients, program participants, and others to resolve difficult, anomalous, eligibility issues related to government program(s). Often, these positions are the second level of review of cases that have been denied at an earlier phase of the eligibility determination process and/or may provide first level review for highly complex, non-standard, or multi-client eligibility cases. In this role, positions report to a higher level manager.

Recruitment Requirements

Knowledge, Skills, and Abilities

• Working knowledge of relevant government program and functions.
• Ability to independently evaluate situations and initiate a course of action that is applicable in problem resolution.
• Ability to review, summarize, and analyze program information, data, business operations, and/or financial statements.
• Ability to determine and ensure compliance with program objectives, laws and regulations.
• Ability to choose an effective course of action or develop appropriate solutions and/or reach conclusions.
• Ability to take action consistent with available facts, constraints, and anticipated consequences.
• Ability to acknowledge and consider client's and organization's range of internal and external priorities in terms of the organization's mission and goals; ability to communicate, in written and oral form, detailed and technical program information, guidelines and standards/statutes/codes/regulations to various audiences to ensure that they understand the information and the message, and to seek compliance.
• Ability to deliver presentations suited to the characteristics and needs of the audience such as negotiating solutions among different parties.

Minimum Education and Experience

Bachelor's degree from an appropriately accredited institution accompanied by at least three (3) years of experience reviewing, evaluating, or processing request for program participation or eligibility; processing claims for benefits or payments; or other benefits program related experience that would include the analysis of criteria, funds, policies, or performance for compliance with program rules, regulations, laws, and /or practices, or Associate's degree accompanied by at least five (5) years of experience reviewing, evaluating, or processing request for program participation or eligibility; processing claims for benefits or payments; or other benefits program related experience that would include the analysis of criteria, funds, policies, or performance for compliance with program rules, regulations, laws, and /or practices; or High School or General Educational Development (GED) diploma and seven (7) years of experience reviewing, evaluating, or processing requests for program participation or eligibility; processing claims for benefits or payments; or other benefits program related experience that would include the analysis of criteria, funds, policies, or performance for compliance with program rules, regulations, laws, and /or practices; or an equivalent combination of education and experience.