Eligibility Specialist III - RUHS at County of Riverside in Riverside, California

Job Description:

ABOUT THE POSITION

The County of Riverside's Riverside University Health System (RUHS) - Medical Center is seeking a Bilingual Eligibility Specialist III. This position will support the Medically Indigent Services Program (M.I.S.P.) in Riverside, CA.

The selected candidate will review, evaluate, investigate, and justify eligibility determinations for medical assistance programs. The Eligibility Specialist III will also be tasked with preparing written reports with recommendations for appropriate corrective action; performing quality control and quality assurance of previously processed aid applications; and serving in a lead capacity over subordinate staff to coordinate and assign work and assist the supervisor in preparing reports and evaluating and training staff. This position will be located in a hospital setting and will require daily face-to-face interactions, as well as compliance with hospital guidelines. Additionally, the incumbent will perform other necessary tasks, including traveling to various locations.

The most competitive candidate will possess strong leadership abilities, organizational skills, knowledge of Medi-Cal programs, knowledge of County/State assistance programs, experience with data analysis, and experience working in a hospital setting. The department also seeks candidates that have experience with Microsoft Office Suite and EPIC.
THIS POSITION REQUIRES THE ABILITY TO SPEAK SPANISH, AS WELL AS ADHERE TO ALL HOSPITAL GUIDELINES.

Meet the Team!

The Riverside University Health System is here for you when you or someone you love is in need of help to achieve and maintain a life of whole health wellness and recovery. Can you see yourself here?

EXAMPLES OF ESSENTIAL DUTIES
• Initially participate in a training program consisting of formalized training and on-the-job training which would give instruction to learn the typical duties performed by the journey level classes.

• Interview applicants for and recipients of one or more aid categories to assist them in the completion and clarification of the application and declaration forms upon which eligibility decisions are based; conduct such interviews in the Medically Indigent Services Program (M.I.S.P.) offices, clinics or in the hospitals.

• Obtain pertinent information concerning such items as income, other financial resources and financial obligations/debts from applicants and recipients; obtain additional information to resolve discrepancies in the applications and declarations by telephone, correspondence or personal interviews.

• Determine eligibility in accordance with established procedures; record information for case records; interpret program regulations and other pertinent material to applicants, recipients and the general public.

• May compute amount of grant authorized and perform other similar required computations; may prepare and maintain other documents associated with the eligibility determining process.

• On the basis of observation, or of need expressed by applicant orally or in specified locations on the applications and declaration forms, refer all applicants and recipients who appear to need social services to designated staff members after completing the appropriate referral forms.

• Review, evaluate and investigate selected cases to determine the accuracy and completeness of all statements of fact given by applicants or recipients during initial and continuing eligibility determinations.

• Contact and interview applicants, recipients, individuals and representatives of business or government organizations for the purpose of verifying facts and/or resolving discrepancies pertinent to the correct determination of eligibility.

• Prepare written reports with recommendations for appropriate corrective action when additional facts affecting eligibility are established and/or prepare written reports justifying the eligibility determination made by the Department in cases appealed by clients.

• Interpret policies, rules and regulations to public officials, clients and the general public; write correspondence.

MINIMUM QUALIFICATIONS
Education: Graduation from high school; possession of a certificate of proficiency issued by the California State Board of Education; or a GED diploma.

Experience: One year of performing duties comparable to Riverside County Health Services Agency's Eligibility Specialist II classification in the Medically Indigent Services Program.

Knowledge of: The goals of public social service agencies, hospitals and health care facilities; the basic laws, rules, and regulations governing eligibility and grant determinations for public assistance programs; interviewing and record keeping techniques; problems requiring referral to the staff; standard office procedures and practices.

Ability to: Interview effectively in a variety of settings; accurately gather, record, and correctly evaluate data necessary for the determination of eligibility for various public assistance programs, correctly interpret the rules and regulation governing eligibility determinations to applicants, recipients, and general public; speak and write effectively; maintain accurate and systematic records identify problems requiring referral to other Department staff.

SUPPLEMENTAL INFORMATION
Other Requirements
License/Certificate: Possession of a valid California Driver's License is required as the candidate will be traveling to other facilities.

What's Next?
This recruitment is open to all applicants. Qualified applicants may be considered for future vacancies throughout the department. Applicants who are current County of Riverside employees and/or current employees of RUHS may be considered before other applicants depending on the volume of applications received.

Qualified applicants may be considered for future vacancies throughout the County.

For questions regarding this recruitment
For specific questions regarding this position, contact Genesis Ochoategui at gochoategui@rivco.org .

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APPLICATION INFORMATION

Veteran's Preference
The County has a Veterans Preference Policy applicable to new hires. To qualify, upload a copy of your (or your spouse's) Member-4 Form DD-214 indicating dates of service, and a copy of your spouse's letter of disability (if applicable) with your application. For privacy reasons, it is recommended that you remove your social security information from the document(s). A Human Resources Representative will review the materials and determine if you qualify for veterans' preference.The Veterans Preference Policy, C-3 is available here: https://rivcocob.org/board-policies

Reasonable Accommodations
The County of Riverside is committed to providing reasonable accommodation to applicants as required by the Americans with Disabilities Act (ADA) and Fair Employment and Housing Act (FEHA). Qualified individuals with disabilities who need a reasonable accommodation during the application or selection process should contact the recruiter for the position noted above. For additional information and/or to obtain the appropriate form for requesting a reasonable accommodation, please visit the Disability Access Office web page located at: https://rc-hr.com/disability

Proof of Education
If using education to qualify or when requested by the recruiter, upload a copy of any license(s), official/unofficial transcript(s), degrees, and/or related employment documents to your NeoGov account at the time of application and before the closing date. Official or unofficial transcripts will be accepted.

If your education was completed outside of the United States, you will need to provide a copy of your Foreign Education Equivalency evaluation from a member of the National Association of Credential Evaluation Services ( NACES ) or Association of International Credential Evaluators, Inc. ( AICE ).

Equal Opportunity Employer
The County of Riverside is an Equal Opportunity Employer. It is the policy of the County of Riverside to provide equal employment opportunities for all qualified persons. All applicants will be considered without regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender, gender identity, gender expression, marital status, ancestry, medical condition (cancer and genetic characteristics), genetic information, or denial of medical and family care leave, or any other non-job-related factors.

Pre-Employment
All employment offers are contingent upon successful completion of pre-employment requirements including a criminal background investigation, which involves fingerprinting. (A felony or misdemeanor conviction may disqualify the applicant from County employment). A pre-employment physical examination and background check may be required.

Probationary Period
As an Approved Local Merit System, all County of Riverside employees, except those serving "At Will," are subject to the probationary period provisions as specified in the applicable Memorandum of Understanding, County Resolution, or Salary Ordinance. Temporary and Per Diem employees serve at the pleasure of the agency/department head.

General Information
Current County of Riverside and/or current employees of the hiring department may receive priority consideration. Qualified candidates may be considered for future County vacancies.

Job postings may close without notice based on application volume. Submit your complete application by the recruitment close date; no late applications are accepted. Ensure all relevant experience/education is reflected on your application/resume, as a failure to demonstrate position requirements may disqualify applicants. A description of job duties directly copied from the job classification or job posting will not be considered.

Please read and follow any special application instructions on this posting. Click the 'Apply' link located on this page to submit your application. For additional instructions on the application process, examinations, Veteran's preference, pre-employment accommodation or other employment questions, please refer to our web site, www.rc-hr.com .

If you are experiencing technical problems, you may contact the governmentjobs.com applicant support desk Monday through Friday, 6 am to 5 pm Pacific Time at support@governmentjobs.com or toll-free 1-855-524-5627.

MEDICAL/DENTAL/VISION INSURANCE: A choice of different medical, dental and visions plan are available to elect. The County provides a Flexible Benefit Credit contribution as governed by the applicable LIUNA Memorandum of Understanding to contribute towards the cost of these plans.

Note: Employees on assignment through the Temporary Assignment Program (TAP) receive different benefits. See the list here .
MISCELLANEOUS RETIREMENT: County of Riverside has three retirement Tiers through the California Public Employees' Retirement System (CalPERS).

• 
  Tier I (Classic Member - Formula 3% @ 60): Applicable to current and former County of Riverside local miscellaneous employees hired prior to 08/24/2012 and did not withdraw CalPERS contributions. The employee contribution is eight (8%) percent.


• 
  Tier II (Classic Member - Formula 2% @ 60): Applicable to local miscellaneous employees 1) hired after 08/23/2012 through 12/31/2012; 2) Previously employed with another CalPERS contracting public agency or a reciprocal retirement system, with a break in service of less than six months between the separation date with the previous employer and the appointment date with the County of Riverside. The employee contribution is seven (7%) percent.


• 
  Tier III (PEPRA New Member - Formula 2% @ 62): Applicable to CalPERS local miscellaneous new members hired on or after the implementation of the Public Employees' Pension Reform Act of 2013 (PEPRA) which took effect January 1, 2013. Effective July 1, 2023 employee contributions are 7.25% and will increase to 7.75% effective July 1, 2024.
  

A new member is defined as any of the following:

A new hire who enters CalPERS membership for the first time on or after January 1, 2013, and who has no prior membership in any California Public Retirement System.

A new hire who enters CalPERS membership for the first time on or after January 1, 2013, and who was a member with another California Public Retirement System prior to that date, but who is not subject to reciprocity upon joining CalPERS.

A member who first established CalPERS membership prior to January 1, 2013, and who is rehired by a different CalPERS agency after a break in service of greater than six (6) months.

CalPERS refers to all members that do not fit within the definition of a new member as "classic members".

Contribution rates are subject to change based on the County of Riverside annual actuarial valuation.

Note:

This summary is for general information purposes only. Additional questions regarding retirement formulas can be sent to retirement@rivco.org or by calling the Benefits Information Line at (951) 955-4981,
Option 2.

If you have prior service credit with another CalPERS agency or within agencies, please contact CalPERS at (888) 225-7377 to determine which retirement tier would be applicable to you. CalPERS is governed by the Public Employees' Retirement Law. The Retirement Law is complex and subject to change. If there's any conflict between this summary and the law, the law will prevail over this summary.
DEFERRED COMPENSATION: Voluntary employee contribution with a choice between two 457 deferred compensation plan options.

VACATION ACCRUAL (Bi-Weekly Accrual):

0< 3 year = 80 Hours (10 Days)
4< 9 years = 120 Hours (15 Days)
10 or more years = 160 Hours (20 Days)

Maximum Vacation leave accumulation is 480 hours.

SICK LEAVE: Four (4) hours Sick Leave accrual per pay period with unlimited accrual.

HOLIDAYS: Normally 12 paid holidays per year

BEREAVEMENT LEAVE: Allowed 5 days (3 days are County paid; 2 additional days can be taken from accrued Sick Leave balance)

BASIC LIFE INSURANCE: Equal to one times annual base salary not to exceed $50,000 of term life coverage. Premiums are paid by the County. Additional Supplemental Life plan is available for employee purchase.

DISABILITY: Short-term Disability benefit pays up to a maximum of $461.54 weekly, payable up to a maximum of 52 weeks.

POST RETIREMENT MEDICAL CONTRIBUTION: A monthly contribution is made by the County towards retiree health insurance offered through the County as governed by the applicable Memorandum of Understanding.

OTHER: There may be other benefit provisions as specified in the applicable Memorandum of Understanding. Please contact the recruiter listed on the job posting directly for more information.

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