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Raul Garcia
Program Eligibility Specialist
Summary
Highly experienced Program Eligibility Specialist with a proven track record of success in analyzing and verifying applications for program eligibility, ensuring compliance with federal and state regulations. Skilled in interviewing applicants, gathering information, and determining eligibility for assistance programs. Proficient in processing and maintaining case files, including documentation and correspondence related to eligibility. Collaborated with other agencies and community organizations to provide referrals and support services to eligible individuals. Conducted outreach and education activities to inform the community about eligibility requirements and available programs. Utilized software and databases to manage and track eligibility data. Stayed up-to-date on changes in eligibility policies and regulations to ensure accurate and timely processing of applications. Assisted supervisors with program administration and quality assurance activities.
Education
Bachelor’s degree in social work, human services
May 2016
Skills
- Eligibility Determination
- Medicaid Rules and Regulations
- Policy Analysis and Interpretation
- Case Management
- Financial Assessment
- Client Interviewing and Intake
Work Experience
Program Eligibility Specialist
- Conducted outreach and education activities to inform the community about eligibility requirements and available programs
- Utilized software and databases to manage and track eligibility data
- Stayed uptodate on changes in eligibility policies and regulations to ensure accurate and timely processing of applications
- Assisted supervisors with program administration and quality assurance activities
Program Eligibility Specialist
- Analyzed and verified applications for program eligibility, ensuring compliance with federal and state regulations
- Interviewed applicants to gather information and determine eligibility for assistance programs
- Processed and maintained case files, including documentation and correspondence related to eligibility
- Collaborated with other agencies and community organizations to provide referrals and support services to eligible individuals
Accomplishments
- Increased program enrollment by 15% through targeted outreach and community engagement
- Developed and implemented a streamlined eligibility screening process, reducing wait times by 30%
- Collaborated with crossfunctional teams to identify and address barriers to program access, resulting in a 5% increase in case approvals
- Conducted comprehensive training on program policies and procedures, improving staff knowledge and consistency in eligibility determinations
- Analyzed program data and identified trends to inform decisionmaking and improve program efficiency
Awards
- Recognition for Outstanding Case Management and Client Advocacy
- Certificate of Merit for Enhancing Program Accessibility for Underserved Communities
- Award for Excellence in Eligibility Determinations and Compliance
- Award for Innovation in Program Eligibility Verification
Certificates
- Certified Eligibility Specialist (CES)
- National Association of Medicaid Directors (NAMD) Specialist in Eligibility and Enrollment (SEE)
- National Certification for Case Management (NCCM)
- Certified Health Insurance Navigator (CHIN)
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How To Write Resume For Program Eligibility Specialist
- Highlight your experience in analyzing and verifying applications for program eligibility
- Demonstrate your knowledge of federal and state regulations governing program eligibility
- Showcase your skills in interviewing applicants and gathering information to determine eligibility
- Emphasize your ability to process and maintain case files accurately and efficiently
- Highlight your experience in collaborating with other agencies and community organizations to provide support services to eligible individuals
Essential Experience Highlights for a Strong Program Eligibility Specialist Resume
- Analyzed and verified applications for program eligibility, ensuring compliance with federal and state regulations
- Interviewed applicants to gather information and determine eligibility for assistance programs
- Processed and maintained case files, including documentation and correspondence related to eligibility
- Collaborated with other agencies and community organizations to provide referrals and support services to eligible individuals
- Conducted outreach and education activities to inform the community about eligibility requirements and available programs
- Utilized software and databases to manage and track eligibility data
- Stayed up-to-date on changes in eligibility policies and regulations to ensure accurate and timely processing of applications
- Assisted supervisors with program administration and quality assurance activities
Frequently Asked Questions (FAQ’s) For Program Eligibility Specialist
What are the key responsibilities of a Program Eligibility Specialist?
The key responsibilities of a Program Eligibility Specialist include analyzing and verifying applications for program eligibility, interviewing applicants to gather information and determine eligibility, processing and maintaining case files, collaborating with other agencies and community organizations to provide referrals and support services to eligible individuals, conducting outreach and education activities to inform the community about eligibility requirements and available programs, utilizing software and databases to manage and track eligibility data, staying up-to-date on changes in eligibility policies and regulations to ensure accurate and timely processing of applications, and assisting supervisors with program administration and quality assurance activities.
What are the educational requirements for a Program Eligibility Specialist?
The educational requirements for a Program Eligibility Specialist typically include a Bachelor’s degree in social work, human services, or a related field.
What are the skills required for a Program Eligibility Specialist?
The skills required for a Program Eligibility Specialist include the ability to analyze and verify applications for program eligibility, interview applicants to gather information and determine eligibility, process and maintain case files accurately and efficiently, collaborate with other agencies and community organizations to provide support services to eligible individuals, conduct outreach and education activities to inform the community about eligibility requirements and available programs, utilize software and databases to manage and track eligibility data, stay up-to-date on changes in eligibility policies and regulations to ensure accurate and timely processing of applications, and assist supervisors with program administration and quality assurance activities.
What are the career opportunities for a Program Eligibility Specialist?
The career opportunities for a Program Eligibility Specialist include opportunities for advancement to supervisory or management positions, as well as opportunities to work in other related fields, such as social work, human services, or public policy.
What is the salary range for a Program Eligibility Specialist?
The salary range for a Program Eligibility Specialist can vary depending on experience, location, and employer. According to the U.S. Bureau of Labor Statistics, the median annual salary for social workers was $50,470 as of May 2021.
What is the job outlook for a Program Eligibility Specialist?
The job outlook for a Program Eligibility Specialist is expected to be good over the next few years. The U.S. Bureau of Labor Statistics projects that employment of social workers is expected to grow by 12% from 2021 to 2031, faster than the average for all occupations.