Eligibility Determination Worker

FALL CREEK FARM & NURSERY; Austin (TX); On-site; USD 40,000 - 50,000; Full time

Benefits offered by this job

Insurance and state benefits

Job summary

Dept of State Health Services in Austin, TX is seeking an Eligibility Determination Worker for the Texas HIV Medication Program to assess patient eligibility and coordinate with ADAP, SPAP, TIAP, and TIAP-PLUS programs.

The role includes training other staff and partner agencies on eligibility criteria, maintaining THMP data, and supporting program communication to improve client access to medications.

Qualifications

• Evaluates program eligibility criteria and processing procedures.
• Trains staff and external agencies on THMP eligibility.
• Assists in planning and coordinating daily THMP operations.

Responsibilities

• Assist with eligibility determinations for new, recertification, and self-attestation applications.
• Provide initial determinations and coordinate with Regional Coordinator for final decision.

Skills

Eligibility determinations

Consultative services

Training staff

Tools

TakeChargeTexas

THMP database

Job description

Career Opportunities: Eligibility Determination Worker (20446)

Posting ID20446-Posted -Dept of State Health Services-HIV Medications Program-Community and Social Services-Not Eligible for Telework- Additional Shifts available (1) -b. $3000 - $4999 per month

DSHS is committed to hiring skilled and dedicated individuals who share a passion for public health to pursue our vision of A Healthy Texas . If you are looking to make an impact and tackle new challenges, we encourage you to consider a career with us.

Employee Benefits:

DSHS offers insurance coverage and other benefits available through the State of Texas Group Benefits Plan administered by the Employee Retirement System of Texas (ERS). To learn more about all the benefits available to you as a DSHS employee and other DSHS opportunities for early career pathways, visit the DSHS Careers Page .

Functional Title: Eligibility Determination Worker
Job Title: Program Specialist I
Agency: Dept of State Health Services
Department: HIV Medications Program
Posting Number: 20446
Closing Date: 09/09/2026
Posting Audience: Internal and External
Occupational Category: Community and Social Services
Salary Range: $3,581.33 - $4,476.83
Pay Frequency: Monthly
Salary Group: TEXAS-B-17
Shift: Day
Additional Shift: Days (First)
Telework: Not Eligible for Telework
Travel: Up to 15%
Regular/Temporary: Regular
Full Time/Part Time: Full time
FLSA Exempt/Non-Exempt: Nonexempt
Job Location City: AUSTIN
Job Location Address: 201 W HOWARD LN STE 200
Other Locations: None
MOS Codes: 16GX,60C0,611X,612X,63G0,641X,712X,86M0,8U000,OS,OSS,PERS,YN,YNS

Brief Job Description:

Performs routine consultative services and technical work to assist in the planning, development, implementation, and coordination of the daily operations and special projects of the Texas HIV Medication Program (THMP). Evaluates and applies operational processes based on program policies and procedures to determine eligibility for THMP clients. Trains other staff, governmental agencies, HIV service agencies, and the public on program eligibility criteria and application processing procedures.

Provides consultative and technical services to agency program staff, other governmental agencies, community/professional organizations and the public to help coordinate and improve client access to the program and to promote client adherence to physician prescribed medication regimens. Contributes to the development of program literature and educational material. Develops, implements and maintains data collection and analysis programs using available software applications. Assists the Special Populations Program Supervisor with planning, assigning and evaluating work duties performed by others. Work is performed under the supervision of the Special Populations Program Supervisor with moderate supervision and limited latitude for the use of initiative and independent judgment.

Essential Job Functions (EJFs):

(30%) Assists with eligibility determinations for new, recertification, and self-attestation applications for medication assistance through the Texas HIV Medication Program in the assigned region. Applications include those for the AIDS Drug Assistance Program (ADAP), State Pharmacy Assistance Program (SPAP), Texas Insurance Assistance Program (TIAP), and Texas Insurance Assistance Program Plus (TIAP-PLUS), and other special or pilot programs administered by the THMP. These applications have been reviewed, demographic information entered into the Texas HIV Medication Program (THMP) database, TakeChargeTexas (TCT), and verification of information entered after review to ensure accuracy and completeness. Reviews proof of HIV positivity, financial eligibility, Texas residency, and insurance status, including both documentations provided by the applicant and verification information provided with the application to determine if the application is approved or incomplete.

(15%) Assists in determining eligibility denials for applicants who do not meet program criteria by providing an initial determination. All eligibility denials will receive a secondary review by the Regional Coordinator for the Eligibility Determination Worker’s assigned region, who makes the final eligibility determination. Additionally, will transfer any