Eligibility Specialist-Title IV-E/Adoption – Lead

Applying For: Job Summary: This is a professional position responsible for determining the eligibility of clients under the federally funded programs for Title IV-E Foster Care, Transition Age Youth and Adoptions. Essential Functions: Establish and maintain a positive working relationship with HFC customersServe as the primary operational lead and point of contact for the RevMax unit during the absence of the program manager, ensuring continuity of operations, workload management, and timely completion of critical functionsDetermine and process initial and ongoing eligibility determinations and redeterminations for Title IV-E Foster Care, Adoption Assistance, and other related federal and state funding programs in accordance with applicable laws, regulations, policies, and proceduresServe as the subject matter expert for Title IV-E and adoption eligibility requirements and provide technical assistance, guidance, and consultation to RevMax staff and agency partnersEnsure all eligibility determinations, redeterminations, and reimbursement claims are accurate, thoroughly documented, and fully compliant with federal requirements, state policy, and agency standardsMaintain complete, accurate, and audit-ready case files within FSFN/CCWIS, ensuring all supporting documentation is properly, indexed, and retained to substantiate eligibility decisions and funding claimsProcess adoption finalizations and related eligibility activities, including verification of required documentation and accurate completion of system requirementsEnter, review, and maintain adoption placement, finalization, and eligibility data within FSFN/CCWIS to support accurate funding and reportingReview complex eligibility cases, identify potential barriers to eligibility, and develop solutions to maximize allowable federal revenue while maintaining compliance with Title IV-E regulationsResearch, analyze, and resolve discrepancies between FSFN/CCWIS, financial systems, Medicaid systems, and other applicable databases to ensure data integrity and accurate claimingConduct quality assurance reviews of eligibility determinations and case documentation to ensure compliance with federal monitoring standards and agency expectationsCoordinate and complete annual federal case reviews, monitoring activities, and other compliance assessments related to foster care and adoption programsAssist with federal, state, and internal audits by gathering documentation, responding to inquiries, researching eligibility determinations, and implementing corrective actions as necessaryCollaborate with Finance, CMOs, DCF Eligibility Specialists, CLS, and other stakeholders to resolve eligibility, reimbursement, and system-related issuesAssist in the reconciliation of eligibility, placement, payment, and claiming information between multiple systems to ensure accurate reimbursement and reportingMonitor pending eligibility determinations and redeterminations to ensure timely processing and compliance with program deadlinesReview, approve, and submit Title IV-E foster care determinations and redeterminations to supervisor for final review and approval, as applicableProvide guidance and support to RevMax staff regarding eligibility policies, procedures, documentation requirements, and best practicesAssist with workload assignments, case prioritization, problem resolution, and coordination of daily unit activities when acting in a lead capacitySupport cross-training efforts and provide backup coverage for Title IV-E, Adoptions, GAP, and related RevMax functions as neededIdentify process improvement opportunities and recommend enhancements to eligibility workflows, documentation practices, reporting processes, and compliance monitoring activitiesMaintain current knowledge of federal and state eligibility policies, funding requirements, system enhancements, and regulatory changes affecting Title IV-E, Adoptions, GAP, and related programsPerform special projects as assigned Qualifications: HS Grad or GED required. Associate’s degree in social work or related field preferred. Two years of office experience required. Experience working within the child welfare system preferred. Strong knowledge of Title IV-E and TANF eligibility determination. Working knowledge of Microsoft Word, Excel and Powerpoint. Benefits: We offer excellent benefits package with tuition assistance, domestic partner coverage, retirement & generous paid time off. Salary: $48K Additional Information: Drug free workplace. Drug testing required. EOE/M/F/D/V. Apply Now Eligibility Specialist-Title IV-E/Adoption – Lead Essential Functions: Establish and maintain a positive working relationship with HFC customersServe as the primary operational lead and point of contact for the RevMax unit during the absence of the program manager, ensuring continuity of operations, workload management, and timely completion of critical functionsDetermine and process initial and ongoing eligibility determinations and redeterminations for Title IV-E Foster Care, Adoption Assistance, and other related federal and state funding programs in accordance with applicable laws, regulations, policies, and proceduresServe as the subject matter expert for Title IV-E and adoption eligibility requirements and provide technical assistance, guidance, and consultation to RevMax staff and agency partnersEnsure all eligibility determinations, redeterminations, and reimbursement claims are accurate, thoroughly documented, and fully compliant with federal requirements, state policy, and agency standardsMaintain complete, accurate, and audit-ready case files within FSFN/CCWIS, ensuring all supporting documentation is properly, indexed, and retained to substantiate eligibility decisions and funding claimsProcess adoption finalizations and related eligibility activities, including verification of required documentation and accurate completion of system requirementsEnter, review, and maintain adoption placement, finalization, and eligibility data within FSFN/CCWIS to support accurate funding and reportingReview complex eligibility cases, identify potential barriers to eligibility, and develop solutions to maximize allowable federal revenue while maintaining compliance with Title IV-E regulationsResearch, analyze, and resolve discrepancies between FSFN/CCWIS, financial systems, Medicaid systems, and other applicable databases to ensure data integrity and accurate claimingConduct quality assurance reviews of eligibility determinations and case documentation to ensure compliance with federal monitoring standards and agency expectationsCoordinate and complete annual federal case reviews, monitoring activities, and other compliance assessments related to foster care and adoption programsAssist with federal, state, and internal audits by gathering documentation, responding to inquiries, researching eligibility determinations, and implementing corrective actions as necessaryCollaborate with Finance, CMOs, DCF Eligibility Specialists, CLS, and other stakeholders to resolve eligibility, reimbursement, and system-related issuesAssist in the reconciliation of eligibility, placement, payment, and claiming information between multiple systems to ensure accurate reimbursement and reportingMonitor pending eligibility determinations and redeterminations to ensure timely processing and compliance with program deadlinesReview, approve, and submit Title IV-E foster care determinations and redeterminations to supervisor for final review and approval, as applicableProvide guidance and support to RevMax staff regarding eligibility policies, procedures, documentation requirements, and best practicesAssist with workload assignments, case prioritization, problem resolution, and coordination of daily unit activities when acting in a lead capacitySupport cross-training efforts and provide backup coverage for Title IV-E, Adoptions, GAP, and related RevMax functions as neededIdentify process improvement opportunities and recommend enhancements to eligibility workflows, documentation practices, reporting processes, and compliance monitoring activitiesMaintain current knowledge of federal and state eligibility policies, funding requirements, system enhancements, and regulatory changes affecting Title IV-E, Adoptions, GAP, and related programsPerform special projects as assigned Additional Information: Drug free workplace. Drug testing required. EOE/M/F/D/V. Heartland for Children (HFC) does not discriminate in employment opportunities or practices based on disability, race, color, religion, sex, national origin, age, marital status, or any category protected by law. HFC will make reasonable accommodations for qualified individuals with known disabilities unless doing so creates an undue hardship for the organization. Heartland for Children is a community-based care lead agency contracted with the Department of Children and Families. © 2024 Heartland for Children. All rights reserved. 1239 E. 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