Eligibility Trainee/Professional (212213)

Job Description:

Kansas Department of Health and Environment within the Division of Health Care Finance has multiple Eligibility Trainee or Eligibility Professional openings in our Topeka office. Analyze the initial applications and reviews (for Long Term Care programs) and supporting documentation provided by applicants to determine eligibility for federal and state medical assistance.  Investigate the applicant circumstances thorough the use of available computer systems (Databases, registries, and informational deposits) researching records provided by the applicant and their contacts to provide the information about the household income, resources, and expenses upon which the eligibility determination is made.

Entering household information and authorizing eligibility within the Kansas Economic and Enforcement System (KEES). Professional completes determinations using State and Federal regulations to determine eligibility for medical benefits based on financial and non-financial criteria. Document the eligibility decision in the electronic case journal and send appropriate system-based and manual correspondence to customers and representatives explaining the results of the eligibility determination and information regarding appeal rights.

Job Responsibilities may include but are not limited to the following:

Eligibility Professionals are expected to be proficient in at least one area of eligibility and use their knowledge to review the implications of proposed federal and state agency eligibility policy and procedural decisions and provide input regarding the impact on applicants, staff, and the operation of medical programs. Use knowledge of State eligibility processes, policies, and procedures governing managed care enrollment to coordinate and provide feedback to policy makers and/or leadership on proposed changes or work processes, interpret guidelines or instructions, resolve conflicts on complex case situations or give guidance to agency and contract staff.

Attend training to develop and enhance current understanding of Kansas Medicaid eligibility programs. Through training and experience, begin to develop expertise in additional areas of determination categories. Provide mentoring/ training through job shadowing and assistance to locate policy resources for Trainee and Professional team peers.

Minimum Qualifications

Eligibility Trainee

Education:  High School Diploma or GED

Licensing & Certification:  Valid Driver’s License – Incumbent is required to have and maintain a valid driver’s license when operating a state vehicle, a private vehicle, or a rental vehicle for the benefit of the State.

Minimum Qualifications:

• Minimum Requirement to Transition to Eligibility Professional: 6 months experience determining Long-Term Care, Elderly and Disabled, or Family Medical eligibility. Education may be substituted for experience as determined relevant by the agency.

Eligibility Professional

Education:  High School Diploma or GED

Licensing & Certification: Valid Driver’s License – Incumbent is required to have and maintain a valid driver’s license when operating a state vehicle, a private vehicle, or a rental vehicle for the benefit of the State.

Minimum Qualifications:

• Residency requirement to reside in Kansas.
• 6 months experience determining Long-Term, Elderly and Disabled, or Family Medical eligibility and has successfully completed KDHE Eligibility Training courses.

Preferred Qualifications

Any additional skills, experiences, or qualifications that would be beneficial, but aren’t strictly necessary.

• Some post-secondary education.
• Word, Excel, PowerPoint, Access.
• Analytical skills.
• Knowledge of Medicaid programs
• Ability to manage competing priorities.
• Experience utilizing computer, imaging, and eligibility determination system.
• Proofreading, editing, attention to detail.

About the Position

• Who can apply: Anyone (External)
• Classified/Unclassified Service: Unclassified
• Full-Time/Part-Time: Full-Time
• Regular/Temporary: Regular
• Work Schedule: Monday-Friday, 8am-5pm (Flexible schedules available).  Some Hybrid or Remote positions available, will be discussed at Interview.
• Eligible to Receive Benefits: Yes
• Veterans’ Preference Eligible: Yes

Compensation: Hourly Pay: $17.40 with opportunity for advancement.

* Salary can vary depending upon education, experience, or qualifications.

• Eligibility Trainee: $17.40
• Eligibility Professional: $18.69

–  After successfully completing new hire training, and 6-month probation, and Eligibility Certification Program.

–  Also, applicants with 6-month prior experience processing Medicaid applications can be hired in at $18.69.  Determination will be made by senior management.

• Eligibility Consultant: $20.63

–  With two years’ experience processing Medicaid applications you can apply as positions become available.

Employment Benefits

• Comprehensive medical, mental, dental, vision, and additional coverage
• Sick & Vacation leave
• Work-Life Balance programs: parental leave, military leave, jury leave, funeral leave
• Paid State Holidays (designated by the Governor annually)
• Fitness Centers in select locations
• Employee discounts with the STAR Program
• Retirement and deferred compensation programs

How to Apply:

Specific instructions for applying, which might include submitting a resume, cover letter, list of references, or completing an online application.

• Please include the Job ID number when emailing.

Job Application Process:  Only applications submitted within our State of Kansas Careers Portal will be considered.

• First Sign in or register as a New User at https://admin.ks.gov/offices/personnel-services/jobs
• Complete or update your contact information on the State of Kansas Careers Portal > My Contact Information page. *This information is included on all your job applications.
• Upload required documents listed for each specific job posting.
• Start your draft job application, upload other required documents, and submit when it is complete.

–  Manage your draft and submitted applications on the Careers> My Job Applications page.

• Check your email and My Job Notifications for written communications from the Recruiter.

–  Email – sent to the Preferred email on the My Contact Information page.

–  Notifications – view the Careers> My Job Notifications page.

Helpful Resources at jobs.ks.gov: “How to Apply for a Job – Instructions” and “How to Search for a Job – Instructions.”

Contact Information:

[email protected]

Salary Range

$ $17.40 to $20.63