What are the responsibilities and job description for the Income Maintenance Supervisor II for Adult Medicaid position at Nash County, NC?
General Statement of Duties
Position supervises eleven Income Maintenance Caseworkers. Medicaid for Private Living (PLA) experience preferred. NC Fast experience required. Strong computer and organizational skills required.
I. PRIMARY PURPOSE OF THE ORGANIZATIONAL UNIT
The primary purpose of the Adult Medicaid unit is to administer the Adult 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 redetermining eligibility on a day-day basis. The unit
must adhere to all guidelines as well as to insure accuracy of eligibility and continued
updating policy and case records.
II. PRIMARY PURPOSE OF THIS POSITION
The primary purpose of this position is to manage, supervise and ensure federally
mandated Income Maintenance services are appropriately provided to applicants and
recipients who meet program eligibility requirements according to state mandated
rules, regulations, policy, procedures and general statues outlined by the state, for the
county. This position requires participation in organizing, planning and decision
making regarding the unit’s personnel for hiring, managing performance issues and
disciplinary actions. This supervisor is responsible for backing up the Adult Medicaid
LTC Supervisor in their absence. These supervisors work closely together, providing
training to staff and monitoring work.
This position is to provide, in a professional and responsible manner, the
administrative, technical and supportive supervision to ten (10) Income Maintenance
Caseworkers IIs, with caseloads of 320 to 350 cases, one (1) Income Maintenance I,
one (1) Contract Income Maintenance II, and one Lead Worker who is responsible for
the taking and process Medicaid applications, redetermining eligibility and case
maintenance for the Adult Medicaid Program for Nash County DSS workers. These
positions are all located at the Department of Social Services.
III. WORK SCHEDULE
Regular Work hours are 8:00 am to 5:00 pm Monday through Friday, subject to afterhours
duty as required.
Essential Duties and Tasks
A. This position is responsible for supervision and maintenance of participation in the
Medicaid Programs: PLA (Medicaid for Private Living), SSI for Adults, SAA,
SAD, MAA, MAD, MAB, MBQ Carolina Access insuring that the Programs are
understood and administered correctly by caseworkers.
B. This position involves decision making on difficult cases, as well as second party
reviews to determine accuracy of benefits to avoid costly errors to the county. If it
is a very difficult case or decision the Supervisor is to discuss the case with the
Income Maintenance Administrator and or the Regional and State Program
Representative.
C. This position may include informational meetings and/or speaking to community
groups or organizations.
D. This position is responsible for the development and maintenance of training for
the Adult Medicaid unit as well as training of new staff And responsible for
ensuring
E. That the unit' s caseworkers complete required administrative papers needed by
the Income Maintenance Administrator, Deputy Director or the Director.
F. The Supervisor has the responsibility of interviewing disgruntled applicant/
recipient and serve in a problem solving capacity with clients as well as their staff.
G. 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 Fraud
Investigator. Cases referred are 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.
H. A minimal amount of time is spent taking and processing applications and reviews.
These cases consist of employee’s relatives or specialized cases that require that
impartiality and confidentiality be maintained. The average caseload is
approximately 8 to 10 cases.
I. A positive attitude must be maintained regarding clients and workload as a guide
for caseworkers, as well as motivational skills for staff during extremely busy
times.
J. Second party reviews are required on all of the caseworkers records at random by
the Supervisor and the Supervisor may use her lead worker to help in this process
V. OPERATIONAL RESPONSBILITIES
A. Planning :
The Supervisor is responsible for setting short and long range goals for the unit,
including quality, timeliness and productivity objectives or case flow objectives.
This requires the use 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. Each year the goals
and objectives are reviewed and revised as the need of the agency and community
changes.
B. Organizing and Directing Work:
? The Supervisor 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 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 workloads for
absent Income Maintenance Caseworkers and vacant positions.
? The Medicaid Supervisor monitors all time reports and approves all leave for the
unit. This position has the responsibility of coordinating coverage of positions when
someone is out, on sick leave or annual leave.
? The Medicaid Supervisor gathers 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
also assesses the need for equipment and supplies.
? The Supervisor 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 Medicaid
Supervisor also reviews cases for compliance with the FRR and BEER reports.
? The Supervisor 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 assure 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 which could cause a loss of federal funds.
VI. PERSONNEL RESPONSIBILITIES
Training
? The Supervisor is responsible for all areas of training for new employees and
retraining of other employees. Training is directed toward the needs of the
particular worker, problems and who needs individualized training, The
employees are and apply the policies and procedures in the Adult Medicaid
manuals. The supervisor meets with employees to discuss their job description
and to discuss the agency’s goals and directives, as well as agency expectations.
After orientation of new staff, the workload is closely monitored for months and
randomly thereafter. The supervisor meets with staff regarding any problems
they may have pertaining to their job and/or any outside influences 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 that relate to the program. She must study the manual, review all
memorandums, county letters, plans and conducts 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.
? Supervisor is to help the Medicaid Unit interpret manual material, county letters;
policy and procedures, as well as answer questions and case problems that may
occur. Training is a continuing process due to ongoing changes in policy and
procedures and the complexity of the programs.
Counseling and Disciplining Employees
? Conferences are planned with the employees to discuss problem cases, answer
questions and to give and receive feedback regarding the workload.
? Conferences are also designed to address 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 difficulties within their
job description or any other problems that might affect the job performance. The
supervisor may suggest that worker seek 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 unit
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 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.
- OTHER DUTIES
related disaster tasks and perform other reasonable tasks requested by the IM
Administrator, Deputy Director or Director.
VII. OTHER WORK CHARACTERISTICS
A. The tools most used by the Supervisor Il are the Adult Medicaid Manuals, North
Carolina. EIS Manuals, computer, calculator, copier, fax machine, telephone and
all other general office equipment. Inquiry access to the Eligibility Information
'System, FSIS System, Nash County Clerk of Court, Child Support Enforcement,
Department of Motor Vehicles, Agency Intranet, Internet, Social Security and
Employment Security.
B. It is imperative that the Medicaid Supervisor ensures that the Income Maintenance
Caseworkers are trained to produce 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.
Alexander vs. Flaherty court order and Medicaid Quality Control reviews a
percentage of the work performed. The State has a tolerance level of 3% for efforts
and overdue reviews As long as the State stays below the tolerance level, federal
sanctions will not be applied to the County.
C. Close visual attention is needed in every phase of the job. A tremendous volume of
reading 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 or
applicant/recipient.
D. The operating hours of the Department of Social Services is 8:00 am
to 5:00 pm, Monday through Friday.
E. Job duties constantly change due to the complexity of the Adult
Medicaid Programs and the ever increasing workload.
Knowledges, Skills and Abilities
a. 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.
b. Knowledge of supervisory techniques relating to affirmative action, civil
rights, personnel recruitment. and North Carolina State Personnel
regulations.
c. A basic working knowledge of the principles, techniques and practices of
Human Services providers.
d. A thorough knowledge of the use of the many public assistance policy
manuals and supporting letters.
e. A considerable knowledge of the needs, problems and attitudes of
disadvantaged people and how best to interact with people with behavioral
or social-economic related-problems.
f. A general knowledge of North Carolina Civil law„ property laws,
insurance forms, and banking procedures, medical terminology, legal
jargon and tax laws.
g. 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.
h. The ability to evaluate, lead and direct the services of a financial program.
i. The ability to represent the agency and the program in meetings,
conferences or through the news media.
j. The ability to function under prolonged high stress levels.
k. The ability to maintain flexibility in dealing with the complexity of
programs and the needs of workers and the clients.
Desirable Education and Experience
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.
