Benefits Eligibility & Referral Social Worker C - Recovery from Addictions Program

The Recovery from Addictions Program (RAP) operated by the Department of Mental Health (DMH) is seeking a dynamic, self-motivated, and experienced individual for a Benefits Eligibility & Referral Social Worker C position, who will function as the Client Benefit Social Worker. The selected candidate will review benefits applications and determine initial and on-going client eligibility for assistance; prepare and deliver explanations of eligibility decisions; issue appropriate authorizations; provide guidance, resources, and placement assistance; evaluate client cases according to applicable rules and regulations; and monitor client cases to ensure compliance with applicable rules and regulations.

Please Note: The selected candidate will work 37.5 hours on first shift, from 8:30AM to 4:30PM, Monday through Friday. The days off are Sunday and Saturday.

Duties and Responsibilities (these duties are a general summary and not all inclusive):

• Screens and analyzes medical benefit request forms received by mail and contacts customers to complete or clarify information needed to facilitate accurate data entry.

• Screens and analyzes medical benefit request forms received electronically to support the deployment of the IE & R Reviews and evaluates verifications to ensure that program requirements are met.

• Evaluates applicable forms and submitted documents such as wage statements, disability supplements, third party liability documentation, etc., to ensure accuracy and completeness of information and forwards supplemental forms to appropriate unit(s).

• Works closely with other staff to resolve issues that may prevent the accurate and timely submission of information onto the agency computer system.

• Provides assistance to data entry staff as required to ensure timely and accurate input of information into agency computer system.

• Represents agency at hearing by preparing and delivering explanations of eligibility determinations.

• Strives for excellence in customer service by responding to all customer inquiries in a professional, efficient, and courteous manner.

• Responds to customer requests for applications and information in an expedient and efficient manner.

• Inputs applicant data into agency’s computer system to establish and update customer data; validates data and makes corrections on agency computer system.

• Performs related work as required, such as maintaining and updating policies and procedures manual, attending staff meetings and training sessions, and completing special projects in accordance with agency direction.

• Treats all clients with dignity and respect through interactions which affirm the individual’s needs and preferences, and by optimally integrating the client’s perspective into all facets of care; will advocate for clients, facilitate timely resolution of client concerns, and assist clients in the exercise of their rights.

• Receives, verifies and processes ambulance / medical transport services invoices for payment. Verify University of Massachusetts Memorial Health Care invoices with the consult / referral form.

• Accesses entitlements / benefit information and performs other assigned projects and tasks as required.

• Performs data entry into outpatient / emergency services database, client profile, and financial databases.

Required Qualifications:

• Ability to actively listen to what other people are saying and asking questions as appropriate.

• Ability to follow a given rule or set of rules correctly in order to arrange things or actions in a certain order.  The things or actions can include numbers, letters, words, pictures, procedures, sentences, and mathematical or logical operations.

• Ability to understanding information and ideas.

• Ability to communicate information and ideas so others will understand

• Ability to read and understanding information and ideas presented in writing.

• Ability to evaluate information against a set of standards and verifying that it is correct.

• Ability to identify the nature of problems.

• Ability to develop constructive and cooperative working relationships with others.

• Ability to look for ways to help people.

• Ability to be aware of others’ reactions and understanding why they react the way they do.

• Ability to work directly with the public, including receiving clients or others doing business with the agency.

• Ability to be open to change (positive or negative) and to considerable variety in the workplace.

• Ability to pay attention to details and be careful and thorough in completing work tasks.

• Ability to be sensitive to others’ needs and feelings, and being understanding and helpful on the job.

• Ability to be pleasant with others on the job and displaying a good-natured, cooperative attitude.

• Ability to maintain composure, keeping emotions in check, controlling anger, and avoiding aggressive behavior even in very difficult situations.

• Must be reliable, responsible and dependable, and fulfilling obligations.

• Must be honest, avoiding unethical behavior, and maintaining confidentiality.

• Must be persistent in the face of obstacles on the job.

• Ability to deal with Stress and accept criticism and deal calmly and effectively with high stress situations.

Preferred Qualifications:

• Experience in benefits eligibility determination.
• Ability to perform a variety of job tasks simultaneously, and flexible to changing priorities and demands.
• Strong communications and interpersonal skills, with ability to provide clear information and reports.
• Solid workload organization and problem-solving skills; capacity to balance workload. 
• Working knowledge of all Microsoft Office applications, including Word, Excel, Outlook, and PowerPoint; Tableau software experience a plus. 
   

About the Recovery from Addictions Program (RAP):
The Department of Mental Health (DMH) in collaboration with the Department of Public Health (DPH) Bureau of Substance Addiction Services operates a statewide Recovery from Addictions Program (RAP) for individuals civilly committed by the courts for substance use treatment for up to 90 days (“Section 35 commitment”).

The program model will provide acute detoxification and early clinical stabilization services as we help clients develop community-based linkages to outpatient supports and substance use disorder treatment providers. The individuals treated within this program will be linked upon discharge to a range of services within the DPH continuum of care for substance use conditions. RAP provides administrative, medical, clinical, and non-clinical services. Its mission to provide quality client-centered care and recovery-oriented treatment.
 
DMH Vision and Mission:
The Department of Mental Health, as the State Mental Health Authority, assures and provides access to services and supports to meet the mental health needs of individuals of all ages, enabling them to live, work and participate in their communities. The Department establishes standards to ensure effective and culturally competent care to promote recovery. The Department sets policy, promotes self-determination, protects human rights, and supports mental health training and research. This critical mission is accomplished by working in partnership with other state agencies, individuals, families, providers, and communities.

Learn more: https://www.mass.gov/orgs/massachusetts-department-of-mental-health

Pre-Hire Process:
A criminal background check will be completed on the recommended candidate as required by the regulations set forth by the Executive Office of Health and Human Services prior to the candidate being hired. For more information, please visit http://www.mass.gov/hhs/cori and click on "Information for Job Applicants."

Education, licensure and certifications will be verified in accordance with the Human Resources Division’s Hiring Guidelines.

Education and license/certification information provided by the selected candidate(s) is subject to the Massachusetts Public Records Law and may be published on the Commonwealth’s website.

ADA Reasonable Accommodation:

If you require a reasonable accommodation with the application/interview process, please contact us at: EOHHS Candidate ADA Requests

For questions regarding this requisition, please contact Executive Office of Health and Human Services, Human Resources at 1-800-510-4122, Option 4.

First consideration will be given to those applicants that apply within the first 14 days.

MINIMUM ENTRANCE REQUIREMENTS:  

REQUIRED WORK EXPERIENCE: At least four years of full-time, or equivalent part-time, professional experience in social work or social casework, claims adjudication, job placement, recruitment, employment counseling, vocational or rehabilitation counseling, credit investigation, educational counseling, legal advocacy, or legal counseling.   

SUBSTITUTIONS:  

-  A Bachelor's or higher degree may be substituted for two years of the required experience on the basis of two years of education for one year of experience.    

-  One year of education equals 30 semester hours.  Education toward a degree will be prorated on the basis of the proportion of the requirements actually completed.  

LICENSES:   Based on assignment, travel may be required.  Those employees who elect to use a motor vehicle for travel must have a current and valid Massachusetts Motor Vehicle Operator's license or the equivalent from another state. 

Salary placement is determined by a combination of factors, including the candidate’s years of directly related experience and education, and alignment with our internal compensation structure as set forth by the Human Resources Division’s Hiring Guidelines. For all bargaining unit positions (non-management), compensation is subject to the salary provisions outlined in the applicable collective bargaining agreement and will apply to placement within the appropriate salary range.

Comprehensive Benefits

When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.

Want the specifics? Explore our Employee Benefits and Rewards!

Title 101 CMR 23.00 (“Regulation”) requires certain agency staff to have received the COVID-19 vaccination and Influenza vaccination, or have taken required mitigation measures, to prevent viral infection and transmission in State Hospitals and State Congregate Care Facilities. The Regulation applies to this position. Successful candidates will be required to acknowledge and attest to your vaccination status for both COVID-19 and Influenza.

An Equal Opportunity / Affirmative Action Employer.  Females, minorities, veterans, and persons with disabilities are strongly encouraged to apply.

The Commonwealth is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity or expression, sexual orientation, age, disability, national origin, veteran status, or any other basis covered by appropriate law.  Research suggests that qualified women, Black, Indigenous, and Persons of Color (BIPOC) may self-select out of opportunities if they don't meet 100% of the job requirements.  We encourage individuals who believe they have the skills necessary to thrive to apply for this role.