What You'll Be Doing

We are seeking an Eligibility Caseworker III specializing in Adult Medicaid Long Term Care and Special Assistance programs. In this role, you'll manage ongoing eligibility determinations, process applications, and ensure accurate case documentation while supporting individuals transitioning to long-term care settings such as skilled nursing, assisted living, or memory care facilities.

As part of the Adult Medicaid (AMA) team, you’ll work onsite at WakeMed’s Main Campus in Raleigh, NC, serving as a liaison between Wake County and WakeMed facilities. You will evaluate Medicaid eligibility for in-county and out-of-county patients, including those with outstanding balances, and collaborate closely with social workers, nurses, and discharge planners. This role requires navigating both NCF and EPIC systems, tracking data manually across multiple tools, and providing regular reports to WakeMed leadership.

Key Responsibilities:

• Determine eligibility for Medicaid LTC and Special Assistance programs
• Accurately enter data and authorize benefits in agency systems
• Evaluate referrals and coordinate with WakeMed for discharges into care facilities
• Maintain thorough knowledge of policy changes and training requirements
• Manage documentation using document management systems
• Track and report data across non-integrated systems (NCF and EPIC)
• Provide support to other case managers as needed
• Attend all mandatory trainings required by both Wake County and WakeMed

About Our Team

The Wake County Department of Social Services team is grounded in a deep commitment to connection, compassion, and community. We bring together experienced professionals who collaborate to support individuals and families through complex challenges, connect them with critical resources, and promote long-term stability. We value insight, innovation, and a solutions-focused approach, and we welcome those who are ready to contribute their expertise to meaningful, community-centered work. Join us in making a lasting difference!

The Basics (Required Education and Experience)

• Associate's degree in Human Services or a related field
• Two years of job-related experience
• Equivalent education and experience are accepted

• Please include ALL prior work experience on your application and resume.

Beyond the Basics (Preferred Education and Experience)

• Two years of experience determining eligibility in Adult Medicaid, Long Term Care, Special Assistance
• NCFast knowledge

How Will We Know You're 'The One'?

• Ability to determine eligibility for Medicaid, Adult Medicaid, Long Term Care, Special Assistance
• Ability to identify issues, obtain relevant information, relate and compare data from different sources, and identify alternative solutions
• Knowledge and strong understanding of Adult Medicaid policy
• Ability to interpret new and changed policies
• Ability to develop and maintain strong relationships with clients by listening to the clients and understanding and responding to identified needs
• Ability to explain Medicaid policy, in layman's terms for beneficiaries, family members, and facility representatives can understand
• Excellent organizational skills and ability to maximize the use of time so that the many diverse tasks associated with the position can be completed in a timely manner
• Ability to accomplish tasks and processes accurately and completely

About This Position

Location: Wake Medical Center7 Raleigh, NC 27610

Employment Type: Regular

Work Schedule: Monday - Friday 8:00am-4:30pm

Hiring Range: 26.16-31.99

Market Range: 26.16 - 37.81

Please include ALL prior work experience on your application and resume.

Posting Closing Date: 7:00 pm on 7/29/2025

What Makes Wake Great

Home to the State Capital, Wake County is one of the fastest growing areas in the nation and the most populous county in the state, with more than 1.1 million residents. The County has received national and international rankings and accolades from publications such as Money, Fortune, and Time magazines as being one of the best places to live, work and play. The central location of the County allows for a short drive to the spectacular mountains or coast. Wake County Government is governed by a seven-member Board of Commissioners, who are elected at-large to serve two-year terms. Wake County Government has a general operating budget of $1.874 billion, employs over 4400 employees, experiences minimal turnover, and is an award-winning leader in wellness and technology initiatives; such as offering employees and covered spouses free access to the Employee Health Center. Wake County Government offers a wide range of training and development opportunities, a stable career in public service with a balance of work and family life, flexible work schedules and a competitive salary and benefits package.

Equal Opportunity Statement

Wake County provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics.

Background Check Statement

Position may require a background check that may include: criminal, credit, motor vehicle, education, and sexual offender registry or others based on job requirements. Unless required by state law, a record of conviction will not automatically exclude you from consideration for employment. Wake County Government is an Equal Opportunity Employer.

Emergency Service Worker Statement

In the event of an emergency, as determined by the County Manager or designee, participation in preparedness and response operations should be expected. Employee may be required to fill a temporary assignment in a role different from standard duties, work hours and/or work location in preparation for, during and after the emergency. Employee may also be required to participate in relevant exercises and regular preparedness training.

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• Wake County Government

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