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The Staff Development and Training Unit is seeking an experienced NC Medicaid Eligibility Specialist with a strong working knowledge of Family and Children's Medicaid (FCMA) or Adult Medicaid (AMED) policies. Candidates with strong knowledge of both programs are preferred. The primary focus of this role is quality assurance; reviewing cases to confirm that the correct rules and Medicaid policy were followed, identifying eligibility errors and internal control errors, and producing clear feedback reports that the Medicaid Services Division can use to support staff retention and ongoing improvement. The selected candidate will also assist with the development of training materials, facilitate training sessions, and provide mentoring and coaching to staff. Responsibilities include delivering training through various platforms, including new hire training, retention training, and new employee orientation.

Additionally, the selected candidate may be assigned other duties in support of the division's lead workers and eligibility specialists as needed.

This position serves as a Staff Development Specialist (Senior Eligibility Specialist - Eligibility Specialist III) supporting the Staff Development and Training Unit within the Medicaid Services Division. Two years of NC Medicaid eligibility experience is required, with a strong working knowledge of either FCMA or Adult Medicaid policy; knowledge of both programs is a significant plus.

The successful candidate will be able to interpret complex rules and regulations, identify eligibility and internal control errors, and produce clear written feedback. They will also possess the following knowledge, skills, and abilities:

• A minimum of 2 years of NC Medicaid experience with a strong working knowledge of either FCMA or Adult Medicaid (AMED) policies and eligibility rules.
• Experience reviewing cases for eligibility errors and internal control errors.
• Ability to coordinate effectively with staff across multiple teams and programs within the division.
• Proficient working knowledge of NC FAST.
• Strong written and verbal communication skills.
• Experience training others or presenting policy in a clear and engaging way.
• Demonstrated ability to develop training content such as interactive learning games and activities, knowledge checks, or structured lesson plans.
• Strong working knowledge of both FCMA and Adult Medicaid (AMED) programs is a significant plus.
• Has worked in a Lead Worker, quality assurance, staff training, or mentoring role.
• Experience with data analytics, such as tracking error trends, summarizing audit findings, or analyzing case data to identify patterns.
• Strong organizational skills with the ability to manage competing priorities and meet deadlines.
• Ability to maintain regular and reliable attendance.
• Ability to establish and maintain effective working relationships with colleagues, community partners, and the general public.

The individual must support the Forsyth County Guiding Principles of We Care: Integrity, Awareness, Accountability, Respect, and Excellence.

Graduation from high school or GED.

A minimum of 2 years of NC Medicaid eligibility experience required, with a strong working knowledge of either Family and Children's Medicaid (FCMA) or Adult Medicaid (AMED) policy. Strong working knowledge of both programs is a significant plus. Experience reviewing cases for eligibility errors and internal control errors is required.

A higher education level may be considered as a substitution for all or part of the experience requirement.

Experience training others, presenting policy, or developing training content (such as knowledge checks, interactive learning activities, or lesson plans) is strongly preferred.

Experience in a Lead Worker, quality assurance, staff training, or mentoring role is strongly preferred.

Experience with data analytics, including tracking error trends and summarizing case or audit data, is strongly preferred.

Two years of NC FAST experience preferred.

Strong organizational skills with the ability to manage competing priorities and meet deadlines.

• Reviews FCMA and Adult Medicaid case records to confirm that the correct rules and Medicaid policy were followed.
• Identifies eligibility errors and internal control errors and documents findings in a clear, structured format.
• Produces written feedback reports for the Medicaid Services Division to support staff retention and ongoing improvement.
• Tracks error trends across staff and programs over time.
• Coordinates with staff across multiple teams and programs to align quality assurance findings with training needs.
• Assists with developing training content, including knowledge checks, interactive learning activities, and structured lesson plans.
• Navigates NC FAST and related systems to review case records and supporting documentation.
• Documents all quality assurance findings and actions in the appropriate case or tracking record.
• Participates in ongoing training and professional development as required.
• Participates in teams, committees, and unit initiatives as assigned.
• Performs related duties as required.

These duties are intended only as illustrations of the various types of work performed. The omission of specific duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position.

This is an onsite position, Monday through Friday, 8:00 AM to 5:00 PM, in an office setting. An alternate schedule of 8:30 AM to 5:30 PM is available. The role requires extensive daily use of a computer and associated systems to review Medicaid case records and produce quality assurance reports.