Adult Medicaid Long Term Care - Eligibility Caseworker III - Tiered Sign-on Bonus Up To $5,000

About the role

We are seeking an Eligibility Caseworker III specializing in Adult Medicaid Long Term Care and Special Assistance programs. In this role, you'll manage ongoing eligibility determinations, process applications, and ensure accurate case documentation while supporting individuals transitioning to long-term care settings such as skilled nursing, assisted living, or memory care facilities. As part of the Adult Medicaid (AMA) team, you’ll work onsite at WakeMed’s Main Campus in Raleigh, NC, serving as a liaison between Wake County and WakeMed facilities. You will evaluate Medicaid eligibility for in-county and out-of-county patients, including those with outstanding balances, and collaborate closely with social workers, nurses, and discharge planners.

Responsibilities

• Determine eligibility for Medicaid LTC and Special Assistance programs
• Accurately enter data and authorize benefits in agency systems
• Evaluate referrals and coordinate with WakeMed for discharges into care facilities
• Maintain thorough knowledge of policy changes and training requirements
• Manage documentation using document management systems
• Track and report data across non-integrated systems (NCF and EPIC)
• Provide support to other case managers as needed
• Attend all mandatory trainings required by both Wake County and WakeMed
• Navigate both NCF and EPIC systems, tracking data manually across multiple tools, and providing regular reports to WakeMed leadership

About the team

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.

Requirements

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

Qualifications

• 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
• 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

Preferred qualifications

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

Schedule

Monday - Friday, 8:00 AM - 4:30 PM

Pay

Hiring range: $26.82 - $32.79 per hour
Market range: $26.82 - $38.76 per hour

Location: Wake Medical Center, Raleigh, NC 27610
Employment type: Regular