Eligibility Analyst – Eligibility Review Program

State of Wisconsin; Madison (WI); Hybrid; USD 56,000 - 59,000; Full time

Benefits offered by this job

Vacation time

Paid holidays

Health plan options

Pension plan with employer match

Flex spending accounts

Well Wisconsin Wellness Program

Employee assistance program

Public Service Loan Forgiveness

Job summary

State of Wisconsin's Department of Health Services seeks an Eligibility Analyst to support the Eligibility Review Program within LEES. The role includes processing background checks, reviewing eligibility, coordinating related reviews, and maintaining confidential records.

You will provide guidance and training materials and interact with partners. This full-time position offers remote flexibility up to 5 days weekly, with a 12-month probation and competitive benefits, in a mission-driven public

Qualifications

• Experience applying laws, regulations, or policies to make eligibility determinations.
• Experience reviewing complex records for completeness, accuracy, and inconsistencies.
• Experience explaining technical requirements clearly to applicants, providers, or partners.

Responsibilities

• Support background check and eligibility administration with accuracy and timeliness.
• Process background check applications and review eligibility or out-of-state equivalency.
• Coordinate related reviews and maintain confidential records.
• Provide responsive technical assistance to applicants and partner agencies.
• Develop guidance and training materials and represent the program at events.

Skills

Laws & regulations experience

Policy interpretation

Documentation & records

Job description

Introduction

The Department of Health Services (DHS) Division of Quality Assurance (DQA), Bureau for Integrity in Care (BIC) is recruiting to fill an Eligibility Analyst position for the Eligibility Review Program within the Licensing, Eligibility, and Enforcement Section (LEES).

The Bureau for Integrity in Care promotes integrity and accountability across Wisconsin's healthcare system. In this role, you'll contribute to protecting the public, improving program transparency, and ensuring equitable access to care. DHS offers a collaborative, mission-driven environment with opportunities for professional growth and meaningful public service.

This Position

• Will work full-time, daytime hours, Monday through Friday.
• Will have the option to work remotely up to 5 days per week. This schedule may vary depending on training or operational needs.
• This position can be headquartered at one of our central or regional offices.
• Must have access to both a private workspace and secure high-speed internet to work remotely.

As an employee of the State of Wisconsin, you'll have access to an amazing benefits package, including:

• 3.5 weeks of vacation, 9 paid holidays and ample sick time; limitations may apply for leave time usage in the first six months.
• Top rated health plan options starting at $47/month for single plans and $117/month for family plans, after 2 months of state service.
• Exceptional pension plan with a 7.25% employer match in 2027 with lifetime retirement payment. Plus, a tax advantaged supplemental retirement savings plan which allows you to save money directly from your paycheck for retirement. Use this Total Rewards Calculator to see the total value of our competitive benefits package!
• Several flex spending accounts: medical, dependent care, commuter, parking and High-Deductible Health Savings.
• Well Wisconsin Wellness Program.
• A free and confidential employee assistance program that offers employees and their immediate family dependents a variety of tools, resources, and professional consultation services to support their health, goals, and overall well-being.
• Public Service Loan Forgiveness Program employer.

Position Summary

As an Eligibility Analyst for the Eligibility Review Program, you will be responsible for the following duties:

• Supporting the accurate, timely, and consistent administration of Wisconsin's background check and eligibility requirements.
• Processing background check applications.
• Reviewing legal eligibility and out-of-state offense equivalency.
• Coordinating substantially related reviews.
• Maintaining confidential and accurate records.
• Providing responsive technical assistance to applicants, providers, and partner agencies.
• Developing guidance and training materials.
• Representing the program at workshops and other events.
• Working with bureau leadership and internal partners.
• Interpreting applicable laws and administrative rules.
• Monitoring program quality and performance.
• Preparing reports.
• Advancing improvements to policies, procedures, and information systems to strengthen screening practices and improve the user experience.

Salary Information

The starting pay is $27.08 per hour (approximately $56,300 per year), depending on qualifications, plus excellent benefits. A 12-month probationary period is required.

Pay for current or former state employees will be set based on the rules that apply to compensation for the applicable transaction. This position is classified as a License/Permit Program Associate Senior and is in pay schedule and range 02/12.

Job Details

All applicants who may be appointed to this position will be required to allow DHS to conduct a background check to determine whether the circumstances of any conviction may be related to the job being filled.

DHS does not sponsor work visas for this position, thus, in compliance with federal law, selected candidates will be required to verify eligibility to work in the United States by completing the required I-9 form upon hire. DHS is not an E-Verify employer nor a STEM-OPT eligible employer.

For positions that allow remote working flexibility, working outside of Wisconsin or in bordering cities will not be allowed except in extremely limited circumstances due to the need to report to an office location in Wisconsin on short notice.

Employees must have access to both a private workspace and secure high-speed internet for remote work option. Mileage reimbursement to the employee's headquarters location is not provided. Remote work flexibility will be discussed in more detail during the interview process.

Qualifications

Minimally qualified applicants will have all of the following:

• Experience applying laws, regulations, or policies to make individual eligibility determinations or administrative decisions, and documenting the rationale
• Experience reviewing complex records for completeness, accuracy, and inconsistencies
• Experience explaining technical requirements clearly and professionally to applicants, providers, or other relevant parties.

Well-qualified applicants will also have one or more of the following:

• Experience working with Background Checks, criminal history review, or health care workforce eligibility
• Experience working with Wisconsin Caregiver background check requirements, including Wis. Stats. s. 50.065 and Wis. Admin. Code ch. DHS 12.
• Experience evaluating whether an offense is substantially related to client care, or comparing out of state offenses with applicable requirements.
• Experience improving review procedures, data quality, guidance materials or training for a regulatory program.

Your letter of qualifications is limited to 1 page.

Deadline to Apply

The deadline to apply is October 19th, by 11:59 pm.

Applicants are strongly encouraged to allow ample time to finalize their applications keeping in mind that technical assistance is only available Monday through Friday 7:45 am - 4:30 pm. Late or incomplete applications will not be accepted.

DHS is an Equal Opportunity and Aff… Veterans are encouraged to apply.