Children's Behavior Health Eligibility Specialist

MPHI; Lansing (MI); Hybrid; USD 69,000 - 102,000; Full time

Job summary

MPHI in Lansing, MI is seeking an Eligibility Specialist for Children’s Behavioral Health. The hybrid role focuses on determining eligibility for behavioral health services and coordinating with MDHHS and partners.

You will review applications, support waiver programs, and prepare essential documentation for ICF/IID placement, while maintaining confidentiality and meeting deadlines.

Qualifications

• Graduate degree in social work, psychology, counseling, nursing, public health, or related human services discipline.
• Two or more years of professional experience in Michigan's specialty behavioral health care system.
• Knowledge of PIHP/CMHSP programs and Medicaid policies.
• Strong written and oral communication skills.

Responsibilities

• Complete screening reviews and determine eligibility for children’s behavioral health services.
• Support waiver applications by reviewing for compliance and approval.
• Use the Waiver Support Application to track enrollment.
• Prepare level of care documentation for ICF/IID placement.
• Advise on referrals for CWP, TEFRA, 1915(i), and related services.
• Coordinate with CMHSP/PIHP staff and partners.
• Respond to inquiries about waiver programs and TEFRA.
• Attend meetings and assist with training and TA.
• Represent MDHHS and MPHI in collaborations.

Skills

PIHP knowledge

Policy analysis

Medicaid knowledge

Interpersonal skills

MS Office

Meeting facilitation

Project management

Confidentiality

Education

Graduate degree in Social Work, Psychology, Counseling, Nursing, Public Health, or related field

Job description

Title:

Children’s Behavioral Health Eligibility Specialist

$68,536 - $102,294.40 / Posted Thru: 10-31-26

Location:

Hybrid – Lansing, MI Office - Must Currently Reside in Michigan

Application Requirement:

Cover Letter Required with Application

Purpose:

Assist the Michigan Department of Health and Human Services in determining eligibility and appropriate service provision options for children and youth with complex behavioral health needs who are at risk for admission to an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) and/or other out-of-home treatment.

Duties and Responsibilities:

• Complete screening reviews and make eligibility determinations based on applicable requirements for children’s behavioral health services including Home Care Children (Tax Equity and Fiscal Responsibility Act (TEFRA)).
• Support Children’s Waiver Program Specialist and Analyst with reviewing applications for children and families applying for the Children’s Waiver Program (CWP) to verify compliance with federal and state requirements, and complete the approval process
• Utilize the Waiver Support Application (WSA) to track enrollment pool for waiver applications.
• Complete level of care documentation gathering and review for ICF/IID placement.
• Assist with consultation on referrals for CWP, TEFRA, 1915(i), Habilitation Supports Waiver and other State Plan services, as needed.
• Contact families, as needed, to address questions related to eligibility for applicable behavioral health waiver programs and ICF/IID.
• Assist with response to inquiries about Waiver Support Application (WSA), CWP, Habilitation Supports Waiver (HSW), and TEFRA eligibility and benefit requirements.
• Consult with Community Mental Health Services Program (CMHSP) staff, Prepaid Inpatient Health Plan (PIHP) staff, and other partners as necessary to address questions related to waiver and/or TEFRA eligibility and ICF/IID.
• Participate in site review preparation and follow-up activities to support waiver programs and ICF/IID.
• Participate in applicable research activities and/or program and policy workgroups/initiatives to support program functions.
• Prepare reports, as requested, regarding status of screening processes and enrollment pool for eligibility.
• Provide training, technical assistance and/or presentations, as requested, to partners to present information about processes for eligibility, determination and available resources.
• Determine when technical assistance (TA) is necessary and refer to appropriate area within MDHHS to support the necessary TA.
• Provide support/back up assigned duties related to CWP, SEDW, and the Michigan Intensive Child and Adolescent Services (MICAS) array.
• Support training initiatives, develop and maintain training guides and resources.
• Track historical guidance and communications.
• Perform other duties as assigned to support bureau goals.
• Attend meetings, as necessary to support job functions.
• Always represent the best interests of MDHHS and MPHI.
• All other duties as assigned.

Qualifications/Requirements:

Education:

Minimum of a graduate degree in Social Work, Psychology, Counseling, Nursing, Public Health, or other human services discipline. Possession of professional licensure is preferred.

Experience:

Two or more years of professional work experience with demonstrated knowledge with Michigan’s specialty behavioral health care system, including Medicaid.

Important Skills and Characteristics:

• Knowledge of programs administered through Prepaid Inpatient Health Plans (PIHPs) and CMHSPs.
• Analysis of policies/programs/laws related to public/behavioral health.
• Knowledge of Medicaid Provider Manual, including programs and policies related to Michigan’s public behavioral health system.
• Effective interpersonal skills, including efficient written and oral communication.
• Proficient use of Microsoft Office applications (i.e. Word, Excel, PowerPoint, Outlook).
• Ability to facilitate meetings with internal and external partners/subject matter experts.
• Ability to manage projects and meet competing deadlines.
• Ability to maintain confidentiality.

Work Environment and Physical Requirements:

Standard office environment. Minimal travel may be required.

RESPONSIBILITY FOR THE WORK OF OTHERS:

No assigned responsibility.

REQUIRED COMMUNICATION:

Will meet with manager as needed or requested for project assignments and/or to review status of work assignments. Will meet with other bureau staff, contracted staff, and/or internal/external partners to collaborate on projects as needed. Will attend scheduled staff and bureau meetings, in person as required.

“For purposes of employment standards, this classification is “Exempt” from the overtime provisions of the Fair Labor Standards Act.”

MPHI works with you to promote health for everyone. Together, we will build a world where tomorrow is healthier than today!

MPHI is an EEO employer that participates with e-verify.