Eligibility Specialist-Title IV-E/Adoption – Lead

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 customers
• Serve 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 functions
• Determine 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 procedures
• Serve 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 partners
• Ensure all eligibility determinations, redeterminations, and reimbursement claims are accurate, thoroughly documented, and fully compliant with federal requirements, state policy, and agency standards
• Maintain 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 claims
• Process adoption finalizations and related eligibility activities, including verification of required documentation and accurate completion of system requirements
• Enter, review, and maintain adoption placement, finalization, and eligibility data within FSFN/CCWIS to support accurate funding and reporting
• Review complex eligibility cases, identify potential barriers to eligibility, and develop solutions to maximize allowable federal revenue while maintaining compliance with Title IV-E regulations
• Research, analyze, and resolve discrepancies between FSFN/CCWIS, financial systems, Medicaid systems, and other applicable databases to ensure data integrity and accurate claiming
• Conduct quality assurance reviews of eligibility determinations and case documentation to ensure compliance with federal monitoring standards and agency expectations
• Coordinate and complete annual federal case reviews, monitoring activities, and other compliance assessments related to foster care and adoption programs
• Assist with federal, state, and internal audits by gathering documentation, responding to inquiries, researching eligibility determinations, and implementing corrective actions as necessary
• Collaborate with Finance, CMOs, DCF Eligibility Specialists, CLS, and other stakeholders to resolve eligibility, reimbursement, and system-related issues
• Assist in the reconciliation of eligibility, placement, payment, and claiming information between multiple systems to ensure accurate reimbursement and reporting
• Monitor pending eligibility determinations and redeterminations to ensure timely processing and compliance with program deadlines
• Review, approve, and submit Title IV-E foster care determinations and redeterminations to supervisor for final review and approval, as applicable
• Provide guidance and support to RevMax staff regarding eligibility policies, procedures, documentation requirements, and best practices
• Assist with workload assignments, case prioritization, problem resolution, and coordination of daily unit activities when acting in a lead capacity
• Support cross-training efforts and provide backup coverage for Title IV-E, Adoptions, GAP, and related RevMax functions as needed
• Identify process improvement opportunities and recommend enhancements to eligibility workflows, documentation practices, reporting processes, and compliance monitoring activities
• Maintain current knowledge of federal and state eligibility policies, funding requirements, system enhancements, and regulatory changes affecting Title IV-E, Adoptions, GAP, and related programs
• Perform special projects as assigned

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.

Pay: $48,000.00 per year

Benefits:

• 403(b)
• 403(b) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Retirement plan
• Tuition reimbursement
• Vision insurance

Work Location: In person

Salary : $48,000