Eligibility Operations Field Specialist

Kansas Department of Health and Environment (KDHE) is comprised of three divisions: Public Health, Environment, and Health Care Finance (which includes the State’s Medicaid program, KanCare). We are the only agency in the nation to have these three entities under one roof, allowing us to take a holistic approach to improving and protecting the health and well-being of all Kansans.

Verification of identity and employment eligibility to work in the United States is required by federal law. KDHE does not provide sponsorships for this position and participates in E-Verify.

About the role

The Eligibility Operation Field Specialist is responsible for determining Medicaid eligibility for applicants, conducting outreach to communities, and providing direct assistance to community partners such as Area Agencies on Aging, county health departments, and Managed Care Organizations. This role involves processing applications, educating the public on Medicaid (KanCare) services, and assisting walk-in clients at community events and partner locations to ensure eligible individuals and families receive necessary healthcare coverage. This position requires frequent travel and some overnight stays.

Responsibilities

• Collaborates with the KanCare Clearinghouse and KDHE eligibility team by assisting consumers with completion of applications, collecting information, and routing applications and supporting documents to the Clearinghouse for timely determination of eligibility.
• Helps Kansas consumers embrace the online application process.
• Maintains current policy and program knowledge to authorize Medicaid benefits and answer inquiries from the general public and agencies.
• Analyzes, interprets, and applies numerous complex policies and regulations to the consumer’s situation to determine eligibility.
• Investigates customer circumstances using available computer information systems, records provided by customers, community sources, and other resources to base eligibility decisions.
• Utilizes fundamental accounting principles and a general understanding of legal terminology and principles in analyzing, quantifying, and applying policy.
• Provides direct outreach for medical assistance programs within the assigned region through various strategies.
• Identifies and engages community partners, providing information and resources regarding medical programs.
• Speaks to the public to provide information, explain programs, and communicate changes.
• Establishes positive relationships with community partners.
• Explains and interprets program requirements and changes for consumers and community partners.
• Serves as the community medical assistance expert and liaison for KDHE DHCF issues.
• Determines eligibility for all medical assistance programs (Family Medical and Elderly and Disabled).

Requirements

• 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.
• One year of experience in planning, implementing, monitoring, and determining eligibility in a Family Medical (FM) or Elderly and Disabled (E&D) unit or other related Medicaid eligibility/customer service experience.

Qualifications

Minimum Qualifications

• High School diploma or GED.
• One year of experience in planning, implementing, monitoring, and determining eligibility in a Family Medical (FM) or Elderly and Disabled (E&D) unit or other related Medicaid eligibility/customer service experience.

Preferred Qualifications

• Four years of experience in planning, implementing, monitoring, and determining eligibility in a Family Medical (FM) or Elderly and Disabled (E&D) unit or other related Medicaid eligibility/customer service experience.
• Education may be substituted for experience as determined by the agency.
• Working knowledge of the Family Medical and the Elderly and Disabled Medical eligibility processes.
• Outcome-driven and analytical skills.
• Ability to apply policy.
• Strong customer service skills.
• Proofreading, editing, and attention to detail.
• Proficiency in Word, Excel, PowerPoint, and Access.

Post-Offer, Pre-employment Requirements

A valid Kansas Tax Clearance Certificate is required for employment. Applicants must obtain this within ten (10) days of a formal job offer. The Kansas Department of Revenue can assist with payment plans if needed.

Benefits

• Comprehensive medical, mental, dental, and vision coverage.
• Sick and 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.

Pay

Hourly Pay Range: $21.13 – $23.31. Salary varies depending on education, experience, or qualifications.

Schedule

Monday-Friday, 8am-5pm (Flexible schedules available). Full-time, regular position with benefits. Veterans' Preference Eligible.