Benefits and Program Eligibility

Description

Jobs in this family assess individuals for eligibility for benefits from public assistance, or provide direct services to program participants and benefit providers, which may include employer contributions.

Typical functions

The functions within this job family will vary by level, but may include the following:

  • Provide case management on assigned caseloads in one of multiple benefit areas and programs.
  • Completes reviews of case documents to ensure compliance with program requirements, federal and/or state statues, policies, and/or procedures.
  • Collaborate with internal and external partners to ensure maximum benefits are obtained for clients.
  • Advocate for clients in a reconsideration or appeals process.

Positions allocated to this series may perform the duties described, or specialize in areas such as unemployment insurance, income maintenance programs, child support, employment services, health and mental health services reimbursement, Medicaid, Medicare, Social Security, Title IV-E programs, and/or veterans’ benefits. The work assigned to positions in this series ranges from specialized vocational-level to the supervision/oversight of staff and operations.

Benefit Program Associate

First-level vocational position responsible for following set rules and procedures to routinely gather and analyze information to make immediate determinations and/or deliver direct services applicable to one of multiple eligibility areas and programs (e.g. food stamps, cash, medical assistance, workforce services, unemployment claims/contributions, etc.). At this level, employees apply guidelines to calculate benefits, if determined eligible, and issue assistance. Employees may also refer applicants to other agencies or other public programs or community resources. At this level, employees perform work under general supervision.

Knowledge, skills & abilities

Knowledge of the purpose and overall objectives of assigned program(s).  Knowledge of state and federal laws and regulations relevant to the assigned program(s). Ability to apply interviewing techniques in practical work situations. Ability to understand and apply complex procedures and regulations. 

Typical qualifications

High School diploma or equivalent and 1-3 years of relevant experience. (Substitutions may be allowed.)

Pay grade
G4

Benefit Program Technician

Second-level vocational position accountable for following set rules and procedures to perform case management on assigned caseloads with responsibility for determining initial and ongoing eligibility and issuing or identifying benefits for assistance, or matters involving employer liability. Employees apply experience to complete reviews of case documents to ensure program compliance and collaborate with internal and external partners to ensure appropriate benefits are obtained. At this level, employees may advocate in a reconsideration process.

Knowledge, skills & abilities

In addition to those identified in the previous level: Knowledge of available community resources and potential partner services. Knowledge of accounting and/or bookkeeping procedures and billing activities. Ability to adapt to changes in policy, procedures, and work assignments. Ability to travel for agency business.

Typical qualifications

High School diploma or equivalent and 2-4 years of relevant experience. (Substitutions may be allowed.)

Pay grade
G5

Benefit Program Specialist

First-level professional position considered an expert in a broad benefit area (e.g. public assistance programs, Medicaid, unemployment, etc.) that evaluates the effectiveness of benefit programs by auditing processes and reporting findings to the stakeholder. Employees may be the lead worker within a benefit area and assign and review the work of others. Employees at this level may assist in establishing public assistance programs in response to legislative mandate and recommend policy or policy revision to governing bodies. At this level, some employees may be responsible for overseeing and/or determining high value claims, benefits, eligibility (e.g. estate management), or tax liability through consideration of a wide range of legal, medical, occupational, and other factors to develop cases based upon complicated facts. At this level, employees may advocate in an appeals process.

Knowledge, skills & abilities

In addition to those identified in the previous levels: Knowledge of the techniques of financial investigation, research, and resource identification.  Knowledge of principles and techniques interviewing, and negotiation. Ability to interpret, explain, and apply policies, rules, regulations, procedures, and requirements, pertaining to the assigned program(s). Ability to provide direction or advice to program staff. Ability to perform community outreach activities.

Typical qualifications

Bachelor’s degree and 0-2 years of relevant experience. (Substitutions may be allowed.)

Pay grade
G6

Benefit Program Senior Specialist

Second-level professional position considered an expert in a more complex public assistance program; evaluates the effectiveness of benefit and eligibility programs by auditing processes and reporting findings to the stakeholder. At this level, employees are lead workers within their area of expertise and are resources for solving complex problems involving multiple programs or issues, coordination of benefits across multiple programs, or reconciliation of benefits or taxes paid in programs involving both state and federal laws and regulations. At this level, employees may advocate in an appeals process.

Knowledge, skills & abilities

In addition to those identified in the previous levels: Knowledge of methods of the organization of informational programs. Knowledge of procedures and techniques used in collecting, organizing, and evaluating statistical and financial data. Ability to lead the work of professional and technical employees engaged in program activities. Ability to analyze and evaluate a variety of laws, rules, regulations, procedures, and technical data pertaining to the assigned program(s); make logical inferences; and draw sound conclusions based on this data.

Typical qualifications

Bachelor’s degree and 1-3 years of relevant experience. (Substitutions may be allowed.)

Pay grade
G8

Benefit Program Supervisor

Positions at this level have supervisory responsibilities of vocational and/or professional employees within a benefit unit and are responsible for the operational results and service delivery of those individuals. Employees at this level may also participate in the work of individual contributors within a benefit area and are accountable for resolving disputes or conflicts which are outside of the decision-making authority or responsibility of individual contributors. Employee supervision includes hire recommendations, training, planning and assigning work, performance assessment, coaching, and progressive discipline. Supervision at this level also requires these employees to have the knowledge and skills to perform and review the work overseen.

Knowledge, skills & abilities

In addition to those identified in the previous levels: Knowledge of principles and techniques of supervision and public administration. Ability to plan, assign, supervise, and evaluate the work of staff, and train employees in work methods. Ability to assess case situations and apply interpretations to ensure conformity with established guidelines. Ability to analyze and evaluate operating programs, policies, and procedures.

Typical qualifications

Bachelor’s degree and 2-4 years of relevant experience. (Substitutions may be allowed.)

Pay grade
G10