Senior Economic Support Specialist

Case Management And Call Center Position

Perform case management and call center functions. Provide referral services for the Southern Consortium, which consists of seven counties. Maintain knowledge of ever changing Federal and State rules, policies and procedures for numerous Income maintenance programs that support essential needs. Such needs include healthcare, food, shelter, childcare, and long-term care services. Programs include Medicaid for the elderly blind and disabled (EBD); other subprograms of Medicaid; Badger Care Plus; Foodshare; Caretaker Supplement (CTS); Childcare authorizations and subsidies, and Emergency Assistance for non-citizens. Supports and promotes the mission, vision, and guiding principles of the Human Services Department. Performs in a manner consistent with the Human Services Department (HSD) Professional Standards and "Commitment to My Co-Workers".

50% Call Center Duties

• Answer calls for the Southern Consortium within the scope of the contract with the State of Wisconsin Department of Health Services.
• Follow policy and procedure as stated in the Southern Consortium Call Center Process Guide while maintaining a high standard of customer service.
• Perform call center functions including but not limited to answering questions, taking applications, reviewing cases, entering changes, scheduling appointments, and determining eligibility for various assistance programs.
• Ability to work with customers of diverse backgrounds using skills of cultural competency, diversity, and inclusive. Ability to use language line/interpreter services to receive/relay accurate information.
• Ability to understand and follow HIPAA and Income Maintenance confidentiality rules
• Use de-escalation and trauma informed care principles to effectively work with individuals who may be hostile, non-cooperative, or evasive both on the phone and in person
• Enter detailed and complete case comments timely after every client interaction.
• Use a One Touch philosophy for Southern Consortium calls, which means processing all action items attached to a case at time of the call. Examples of action items include but are not limited to renewals, six-month report forms, alerts, discrepancies, applications, and documents.
• Navigate Genesys, the internet-based system used to receive/make calls to/from customers. Ability to collect telephonic signatures and transfer calls.

45% Determine eligibility and provide ongoing case management.

• Provide case management to participants of economic support in person, on the phone, walk in requests and through the ACCESS website.
• Process applications, renewals and change reports, within established timelines and following the policies, regulations and processes set by County, Consortium, State and Federal regulations. This includes determining initial and ongoing eligibility.
• Explain agency services and benefit delivery. Have knowledge of client's rights and responsibilities while aiding in the application process.
• Determine eligibility through interviews, reviewing documents and collateral investigations; enter information into a computerized eligibility system..
• Maintain accurate, well documented case files. Effectively utilize case management tools.
• Complete annual training requirements mandated by the state including but not limited to 12 hours of professional development, cultural competency, civil rights, Social Security Training, and HIPAA.
• Resolve all case discrepancies using various means available. This includes contact with other agencies, investigations, and cross matches/data base searches.
• Prepare fraud and program integrity referral. Prepare for/participate in/testify at fair hearings and court proceedings.
• Investigate complaints and fraud allegations received from the Office of Inspector General (OIG), outside agencies and the public. Use the Benefit Recovery Investigation Tracking System (BRITS) to make proper referrals for fraud investigation.
• Assist clients with understanding able bodied adults without dependents (ABAWD) status and the reason for Foodshare Employment and Training (FSET) referrals. This includes monitoring time clocks and determining exemptions.
• Accurately code paperwork for scanning into the electronic case file (ECF).
• Review and process applications and changes received from the Federally Facilitated Marketplace (FFM) under the Affordable Care Act (ACA). Understand and explain to customers the referral process between the State of Wisconsin and the FFM.
• Successfully navigate CWW (Cares Worker Web), KIDS, BRITS, CARES Mainframe, Forward Health Portal, DHS Website, SAVE, ECF, Genesys, CCAP, Kelley Blue Book, NADA, DMV, GIS Tax Database, Jail Roster, Department of Correction website, Cornerstone Training, and ACCESS.
• Independently seek out policy changes, Operations Memorandums and CWW process changes for Income Maintenance Programs. Ability to apply critical thinking to follow policy and process in various forms.
• Maintain high level of accuracy to meet state and federal performance standards
• Respond timely to emails and voicemails from customers, co-workers, and community partner agencies regarding public assistance cases and eligibility.
• Prepare statement of case action to the Department of Hearings and Appeals as the result of the filing of a Fair Hearing by a client, prepare exhibit list/exhibit packet for petitioner and ALJ.
• Represent agency at fair hearings which includes defending agency action being appealed and answering both the petitioner and ALJ's questions.
• Respond to Income Maintenance Quality Assurance, FoodShare Quality Control, and Internal Quality Assurance reviews when needed.
• Complete motivational and interactive interviews to gather complete, detailed information needed to determine benefit eligibility
• Be knowledgeable of public assistance eligibility requirements and educate customers on program options and budgets
• Understand and explain the difference between Medicaid and Medicare benefits.
• Assess individual and family needs to make appropriate referrals to other units within HSD as well as outside agencies. Maintain effective relationships with partner agencies such as Crisis and the Aging Disability Resource Center (ADRC).
• Counsel and educate clients on options related to their eligibility, potential programs- available for support, and resources available for EBD/LTC clients.
• Process referrals from CLTS for Children's Waivers.
• Facilitate Income Diversion processes for clients and nursing homes.
• Act on change reports, resolve issues, and correspond with managed care organizations.
• Evaluate Undue Hardship requests.
• Determine if divestment of assets has occurred and impose penalty periods when needed.

5% Other duties as assigned

• Participate in Human Services Department work groups such as Difficult Conversations, Diversity and Inclusion, and Trauma informed Care.