ELIGIBILITY & COMMUNITY OUTREACH WORKER

County of Sandoval; Farmington (ME); On-site; USD 26,000 - 32,000; Full time

Job summary

The County of Sandoval is seeking a qualified Eligibility Determination Clerk within the Community Health Program to conduct in-depth client interviews and assess CHP eligibility for Medicaid and related programs. You will explain programs, make referrals to community resources, and process enrollment applications with state systems.

Essential duties include interviewing clients, determining eligibility based on income and assets, updating records, and coordinating with health resources while

Qualifications

• High School Diploma or GED from an accredited institution.
• Two years of eligibility determination in a public entitlement program and specialized computer system experience.

Responsibilities

• Conducts in-depth personal interviews to determine CHP eligibility for Medicaid, ACA, and related programs.
• Processes enrollments and eligibility determinations using YESNM PE 2.0, Healthcare.gov, and CHIS.
• Maintains case files and client tracking to report on program participation and outcomes.
• Provides referrals to community resources and educates clients about CHP programs.

Skills

Data gathering

Customer service

Communication skills

Interpreting policies

Public health programs

Education

High School Diploma or GED

Tools

MS Office

Job description

Department: CS Health Program Pay: $19.68-$22.64 Close Date: 10-15-2026

Job Description

GENERAL PURPOSE: Under basic supervision, conducts in-depth personal interviews with clients to obtain applicable information related to Medicaid, Affordable Care Act and Health Care Assistance program eligibility; evaluates needs based on appropriate factors to determine eligibility for the Sandoval County Community Health Program (CHP); explains programs, makes referrals to community resources, updates proprietary database, and processes enrollment applications.

Minimum Qualifications

Education and Experience: High School Diploma or GED equivalent from an accredited institution. Two years of eligibility determination in a public entitlement program and specialized computer system experience.

Required Licenses or Certifications

• Valid New Mexico driver’s license or ability to obtain a valid New Mexico driver’s license within 30 days of hire.
• Presumptive Eligibility/Medicaid On-Site Application (PE/MOSSA) determiner certification is required within six months of hire.
• Affordable Care Act Insurance Enrollment Counselor Certification is required within six months of hire.
• Notary Public Certificate is required within six months of hire.

Additional Requirements

• Ability to maintain a valid New Mexico driver’s license
• Must pass a background check applicable to position.

Supervision Received and Exercised

Position reports to the Community Health Program Manager and does not supervise staff.

Essential Job Functions

The following duties ARE NOT intended to serve as a comprehensive list of all duties performed by all employees in this classification, only a representative summary of the primary duties and responsibilities. Incumbent(s) may not be required to perform all duties listed and may be required to perform additional, position-specific duties. Assists Community Health Program (CHP) clients with information and services for a variety of public health programs and support services; performs duties within scope of authority and training and in compliance with required internal and external policies and procedures and state regulations; job duties may vary according to assignment. Conducts in-depth personal interviews with clients to obtain applicable information related to Medicaid, Medicare Assistance Programs, Supplemental Nutrition Assistant Program (SNAP), Temporary Aid to Needy Families (TANF), Low Income Home Energy Assistant Program (LIHEAP), and Health Assistance Program (HCAP) eligibility; assists consumers with Affordable Care Act; analyzes needs based on appropriate factors such as household income, resources, and assets to determine CHP eligibility. Researches and verifies client information; determines client eligibility and appropriate level of assistance. Identifies client needs, explains CHP programs and makes appropriate referrals to community resources. Performs front desk reception duties including answering phones, scheduling coordination, and providing general information to the public regarding Health Commons Agency programs, resources and referrals as necessary. Processes applications, eligibility determination, enrollments and referrals through YESNM PE 2.0, Healthcare.gov, and Sandoval Community Health Information System (CHIS); scans required documentation and submits to appropriate programs; conducts follow up with clients and agencies until resolution of application is complete. Assists clients to fill out applications and refer to other regional agencies and community service programs. Maintains case file records and client tracking system; check client status and report data on program participation and outcomes. Assists with community outreach and public assistance programs as assigned; conduct home visits as needed. Trains and cross-trains in a variety of public health programs. Enters data into the Consumer Assistance Tracking System in accordance with program policies. Performs other job-related duties as assigned.

Required Knowledge of

• County and departmental policies and procedures.
• Methods, practices and procedures for assisting public health clients.
• Principles of customer service and public relations.
• Effective communication principles and practices including oral and written communication.
• Regional community service agencies, community resources, public health programs and other public assistance programs for appropriate referrals.
• Principles of record keeping and confidential records management.
• English usage, spelling, grammar, and punctuation.
• Business computers and MS Office software applications.
• Methods for research, data collection, and report development.

Required Skill in

• Interpreting, applying, and explaining CHP program standards and procedures, applicable Federal rules and regulations, and County policies and procedures.
• Gathering data and verifying information.
• Reviewing, updating, and maintaining files, reports, and documentation for public assistance programs.
• Utilizing standard personal computer software programs and specialized state and County software.
• Communicating effectively verbally and in writing, including customer service and public relations.
• Establishing and maintaining effective working relationships with employees, other agencies, and the public, including meeting and dealing tactfully with the public.
• Interpreting and administering policies and procedures sufficient to administer, discuss, resolve, and explain them.
• Strong customer service skills.

Physical Demands / Work Environment

Work is performed in a standard office environment and is generally sedentary in nature. Work frequently involves extended periods of time viewing a computer monitor and operating a keyboard. Work frequently requires speaking, hearing and utilizing a phone, calculator, cell phone, copier or fax machine. Work may occasionally be performed in a temporary location. Essential and supplemental functions may require maintaining physical condition necessary for sitting, walking or standing for prolonged periods of time, stooping, and lifting books or files of approximately 20 pounds or less. Occasionally may be exposed to infectious diseases when dealing directly with members of the public or in public settings. Operates a County vehicle to conduct community outreach presentations about CHP services and attend meetings and training; occasionally may be exposed to extreme weather conditions when traveling to County facilities or remote locations to perform work.

We foster an organization that engages its citizens and exceeds their needs. We promote organizational excellence through collaborative leadership, improved communications and the development of employee learned programs. We ensure employees' skills and County policies are aligned with County goals and objectives to sustain investment in public and organizational infrastructures.

Sandoval County is always recruiting for hardworking, qualified people to join our workforce. If you have a passion for public service and for serving the residents of our county, we could be a great fit for you!