Under general supervision, determines financial and residential eligibility of applicants to the California Children's Services Program for diagnosis and treatment of medical conditions or disabilities; manages assigned caseload; and does other work as required.
Receives and reviews applications for financial eligibility for medical care and treatment provided by County participation in the California Children's Services Program; interviews parents of children to obtain and evaluate information necessary to establish financial and residential eligibility; determines medical eligibility for specific medical services; authorizes payments for those medical services that do not require consultation with a health professional; explains the scope and limitations of the program, procedures and authorization processes; obtains data on income, share of cost and repayment obligation; discusses repayment schedules and plans with parents; prepares certification that family meets necessary requirements; manages financially and socially complex cases; consults with the program manager regarding appeals and problem cases; locates and researches other medical assistance programs for which clients may qualify; screens for eligibility to and explains the requirements and application processes of other medical assistance programs, such as MediCal and SSI, and assists clients in applying to those programs; reviews ongoing cases for continued financial eligibility and parents' compliance with treatment and repayment schedules; interprets the rules and regulations of the program for applicants, physicians, hospitals, and other providers; assists families ineligible for services of the program to locate alternate care; interacts with and communicates program-related information to clients experiencing grief and emotional crises; refers families to community resources as appropriate; acts as program consultant to medical therapy conferences; coordinates orthodontia screening conferences, which includes acting as a program consultant for orthodontists and educating families regarding program eligibility; maintains case records; prepares reports and statistical data related to cases; inputs, accesses, analyzes and prints data using a computer terminal; orients clerical staff and others to the CCS program; and may assist in training other California Children's Services Specialists.
Knowledge of:
California Children's Services Specialist I
Working knowledge of:
Some knowledge of:
- Interviewing techniques for obtaining factual information.
- Medical terminology. Methods of organizing work.
- Record-keeping practices and procedures.
- Human motivation and behavior.
California Children's Services Specialist II
Working knowledge of the above, plus:
- Client or patient casework.
- Principal sources of information necessary to establish eligibility for public health assistance.
Some knowledge of:
- Specialized community resources available to children.
Ability to:
- The following abilities apply to level I as trainee and level II as journey.
- Read, understand, explain and apply complex regulations and policies governing public and private medical assistance programs.
- Gather, record and evaluate information necessary to determine initial and continuing eligibility for assistance.
- Exercise initiative and resourcefulness in locating other medical assistance programs, in order to facilitate cost containment.
- Exercise independent judgment and recognize those situations that require consultation with the program manager.
- Understand the emotional and social problems of families with terminally ill or severely disabled children.
- Organize and process transactions to meet frequent deadlines.
- Maintain systematic and accurate records.
- Recognize problems requiring referral to medical and allied resources.
- Establish and maintain effective working relationships with others.
- Communicate effectively in written and oral form.
- Prepare reports and statistical data.
- Perform basic arithmetic calculations.
- Input, access and analyze data using a computer.
Training and Experience
Any combination of training and experience, which would provide the required knowledge and abilities, is qualifying. A typical way to obtain these knowledge and abilities would be:
California Children's Services Specialist I
One year of experience working in a medical or human services setting which has included client or patient contact.
OR
Thirty semester units of successfully completed college level coursework in psychology, social work, sociology or a closely related field.
California Children's Services Specialist II
One year of experience in a medical or human services setting which has included interviewing, casework and application of rules and regulations.
Special Requirements/Conditions:
License Requirement: Possession of a valid California class C driver license, or the ability to provide suitable transportation which is approved by the appointing authority.