I. Principal Purpose of the Organization Unit
The primary purpose of the Family and Children’s Medicaid Supervisor is to administer the Family and Children’s Medicaid Program for Nash County according to federal, state and county guidelines as well as the Alexander vs. Flaherty Exit court order. This unit is responsible for taking and processing applications and re-determining eligibility on a day-to-day basis. The unit must adhere to all guidelines as well as to ensure accuracy of eligibility and continued updating policy, records, job aids and NC Fast System.
II. Primary Purpose of this Position
The primary purpose of this position is to provide, in a professional and responsible manner, the administrative, technical and supportive supervision to 18 Income Maintenance Caseworker II’s, 1 Income Maintenance Caseworker I and 2 Income Maintenance Caseworker III’s (Lead Worker). 15 of the 24 Income Maintenance Caseworker II’s have ongoing caseloads of approximately 1000 to 1200 each. The other 8 remaining Income Maintenance Caseworker II’s are responsible for all application intakes and processing whether face-to-face, Epass, online, mail-in/drop offs etc. These total 26 staff are split between 2 Supervisor II’s with 1 having 10 staff and the other having 16 staff. All caseworkers under this Supervisor are responsible for determining eligibility and case maintenance for the Family and Children’s Medicaid Program for Nash County. This program’s positions are all located at the Department of Social Services. This position is responsible for interpreting and understanding policy and regulations for the MAF (Medicaid for Families), MIC (Medicaid for Infants and Children), MXP (Adult Medicaid Expansion), MPW (Medicaid for Pregnant Women), NCHC (North Carolina Health Choice), IAS and HSF (Foster Care and Adopted Children), BCCM (Breast and Cervical Cancer), FPP (Family Planning Program, ANB (Automatic Newborns), TMA (Transitional Medicaid – income disregarded when certain criteria are met) and all SSI eligible children (age 19 and under) and ensuring the Program is understood and administered correctly by caseworkers and within the NC Fast System. This position is also responsible for Outreach for Family and Children’s Medicaid, which may include informational meetings or speaking to community groups or organizations. This position involves decision making on difficult cases, as well as reviewing cases to determine accuracy of benefits to avoid costly errors or sanctions to the county resulting in county charge backs. This position is responsible for development and maintenance of a training plan for both Family and Children’s Medicaid policy, as well as function and processes within the NC Fast system for new staff and seasoned staff also. This position is responsible for ensuring that the unit’s caseworkers complete required administrative paperwork and all reports timely. This position must also complete an employee’s annual evaluation, which may include corrective actions for a marginal employee. In case of a man made or natural disaster, this worker would be responsible for operation of an emergency disaster shelter and/or perform other duties as assigned by the Income Maintenance Administrator, Deputy Director or Director.
1.Clients are referred to this position by the Director, Deputy Director, Income Maintenance Administrator, Medical providers, Social Workers, Civic Leaders, Elected officials, and school personnel. The clients referred can be dissatisfied, irate, uncooperative and/or disagreeable. The Supervisor II has the responsibility of interviewing this segment of Family and Children’s Medicaid applicant/recipient and serve in a problem-solving capacity.
2.Case actions are subject to review by the Income Maintenance Administrator, Director, Deputy Director, Monitoring Team and Medicaid Representative from the State and Region as well as Quality Control.
3.The Supervisor makes the final decision regarding Family and Children’s Medicaid cases. If it is a difficult decision the case is discussed with the Income Maintenance Administrator or the Regional and/or State Program Representatives.
4.The Supervisor reviews and discusses with the Income Maintenance Caseworkers any cases in which they suspect fraud may be occurring. If after reviewing, it is determined that there is legitimate misrepresentation, the case is referred to the Fraud Investigator. Cases referred are those in which the recipient has received benefits erroneously. If a caseworker is scheduled to appear in court in regards to a fraud case and is unable to do so the supervisor will fill the agency’s responsibility to have representation in court.
5.Training for all staff is a necessary on-going responsibility of this position as well as training of new staff.
6.The Supervisor is responsible for taking and processing applications and recertificatons. These cases consist of employees, employee’s relatives or specialized cases that require that impartiality and confidentiality be maintained. The average caseload is approximately 80 – 90 cases.
7.A positive attitude must be maintained regarding clients and workload as a guide/example for caseworkers as well as motivational skills for staff during extremely busy times.
IV.OPERATING RESPONSIBILITIES
1.Planning – The Supervisor II is responsible for setting short-and-long range goals for the unit to target quality, timeliness and productivity objectives or case flow objectives. This requires the monitoring of productivity reports, quality control reports and complaints received from the client and the community. The goals of the individual caseworkers are reviewed and incorporated into the unit’s goals. The goals and objectives are reviewed and revised as frequently as needed based on the need of the agency and community change.
Organizing and Directing – The Supervisor II is responsible for directing the day-to-day activities of the Income Maintenance Caseworkers and assigning work. Constant assessments of the workload are conducted and the staff is organized and/or shifted to meet the demands of the work. Assignments are made in an effort to ensure equitable distribution of workloads. The flow of work must be organized to adequately cover the workloads for absent Income Maintenance Caseworkers and/or vacant positions.
Time Reports and Leave – The Supervisor II monitors all time reports and approves all leave for the unit. This positon has the responsibility of coordinating coverage of positions when someone is out, on sick leave or annual leave.
Financial Management – The Supervisor II gathers statistical data regarding production and individual job performance. This data is used to make recommendations to the Income Maintenance Administrator regarding budget and staffing needs. The Supervisor II also assesses the need for equipment and supplies.
Review – The Supervisor II is responsible for monitoring work to ensure that medical services are being provided to applicants/recipients in a timely manner. The monitoring process also determines whether the completed work meets the acceptable qualitative standards. Statistical records are compiled from monthly production schedules prepared by the Income Maintenance Caseworkers and the daily activity sheets are reviewed. Reviewing case records is crucial because of the varied types of medical coverage and the need to assess all applicants/recipients for whatever coverage they are entitled to receive. Failure to properly evaluate all individuals can result in loss of medical coverage and create county errors. The Supervisor II also reviews case files for compliance with the FRR and BEER reports.
Setting Work Standards – The Supervisor II is responsible for setting work standards. Federal, State, County and Agency policies are reviewed to ascertain that all time frames, policies and guidelines are adhered to and that all deadlines are met to ensure accurate payments and benefits are authorized timely to applicants/recipients. Failure to meet the standards could cause a delay in the recipient/applicant receiving needed medical attention or placement. The applicants/recipients could receive penalty payments and the county could be sanctioned/charged and could cause a loss of federal funds as well.
2.Personnel Responsibilities
Training – The Supervisor II is responsible for all areas of training for new employees and retraining of seasoned staff in both Family and Children’s Medicaid policy, new and/or updated Job Aids and NC Fast System. Training is directed toward the needs of the particular worker, encountering particular problems and who needs individualized training. The employees are requested to read and apply the policies and procedures in the Family and Children’s Medicaid manuals. The Supervisor II meets with employees to discuss their job description and to discuss the agency’s goals and objectives as well as agency expectations. After orientation of new staff the workload is closely monitored for at least 6 months and randomly thereafter. The Supervisor counsels with staff regarding any problems they may have pertaining to their job and/or any outside influence that may have an effect on their job performance. Daily monitoring and discussion is an aspect of the informal training plan. The Supervisor reads publications, bulletins and news articles that relate to the program. She must study manuals, review all memorandums, county letters, plans, terminal messages, new and updated NC Fast Job Aids and conduct unit meetings to disseminate the information. The Supervisor is responsible for all programmatic training. Unit meetings are held by the Supervisor as often as needed. This is to help with the Medicaid Unit interpreting manual materials, county letters, policy, procedures, terminal messages and new and updated NC Fast Job Aids. Training is a continuing process due to constant changes in policy, procedures, NC Fast system updates and the complexity of the programs.
Counseling and Disciplining Employees – Conferences are planned with employees to discuss problem cases, answer questions and to give and receive feedback regarding the workload. Conferences are also designed to discuss any concerns workers may have regarding their job performance in an effort to improve and eliminate the problems in order to obtain maximum performance. The Supervisor must be available to counsel employees with problems concerning duties within their job description or any other problems that might affect the job performance. The Supervisor may suggest that worker seeks counseling through the Employee Assistance Program or may refer them. If necessary, the Supervisor may schedule a conference with the Income Maintenance Administrator to discuss disciplinary action to be taken. The Supervisor keeps an “Open-Door” policy to address issues that cannot wait until the next scheduled conference.
Selection and Appraisal of Employees – The Supervisor, along with the Income Maintenance Administrator is responsible for interviewing prospective employees for the Medicaid Unit, using a structured interview. The Supervisor makes a recommendation to the Income Maintenance Administrator and together they make a final recommendation to the Director. The Supervisor conducts formal annual evaluations to evaluate job performance in order to offer commendation for outstanding performance and to address areas in which improvement is needed. The formal evaluation is based upon daily observations, client/worker and supervisor/employee relationships. Case records are monitored to evaluate staff knowledge and skills. The Supervisor is concerned with both the quality of performance and the quantity of accomplishment. An adopted county document is used in completing the evaluation.
3.Employees Supervised
23 Income Maintenance Caseworker II’s
1 Income Maintenance Caseworker I
2 Income Maintenance Caseworker III’s
Staff are divided between the 2 Supervisors within the department with 1 Supervisor having 10 staff and the other having 16 staff.
V.OTHER WORK CHARACTERISTICS
1.The tools most used by the Supervisor II are the Family and Children’s Medicaid Manual, Fast Help, Job Aids, Terminal Messages, computer, calculator, copier, fax machine, telephone, scanner and all other general office equipment. Also access to the Eligibility Information System, NC Fast, Nash County Clerk of Court, Child Support Enforcement, Department of Motor Vehicles, Agency Intranet, Internet, Social Security Administration and Employment Security Commission.
2.It is imperative that the Medicaid Supervisor II ensures that the Income Maintenance Caseworkers are trained to produce quantity as well as work in a quality manner in order to comply with the 3% tolerance level. With quality and timely work, we eliminated Federal sanctions, overdue reviews, penalties, overpayments and underpayments. Medicaid Quality Control reviews a percentage of the work performed. The state has a tolerance level of 3% for errors and overdue reviews. As long as the State stays below the tolerance level, Federal sanctions will not be applied to the county.
3.Close visual attention is needed in every phase of the job. A tremendous volume of reading, and interpretation is required as well as writing and use of various kinds of office machines. Monitoring and close examination of case records is required along with observation of staff. Intense mental concentration must be maintained so that errors are avoided, which could have a negative impact on the agency, State and/or applicant/recipient.
4.The operating house of the Department of Social Services is 8:00 am to 5:00 pm, Monday through Friday.
5.Job duties constantly change due to the complexity of the Family and Children’s Medicaid programs and the ever-increasing work and caseloads.This position requires a general knowledge of all Social Services administered social and financial services with a more thorough knowledge of the specific program of medical services.
Knowledge of supervisory techniques relating to affirmative action, civil rights, personnel recruitment and North Carolina State Personnel regulations.
As basic working knowledge of the principles, techniques and practices of Human Services providers.
A thorough knowledge of the use of many public assistance policy manuals and supporting letters.
A considerable knowledge of the needs, problems and attitudes of disadvantaged people and how to best interact with people with behavioral or social-economic related problems.
A general knowledge of North Carolina Civic law, property laws, insurance forms, and banking procedures, medical terminology, legal jargon and tax laws
The ability to maintain effective working relationships with administrative superiors, other professionals, other agencies and the community at large as well as the clients that we serve.
The ability to plan, evaluate, lead and direct the services of a financial program.
The ability to represent the agency and the eligibility program in meetings, conferences and through the news media.
The ability to function under prolonged high stress levels.
The ability to maintain flexibility in dealing with the complexity of programs and the needs of workers and the clients.
Three years of experience as a caseworker or investigator in an Income Maintenance program, preferably with one year of supervisory experience; or an equivalent combination of training and experience.
This position must maintain a valid North Carolina Driver’s License and maintain suitable insurance coverage on a safe and reliable automobile.