Dane County Department of Human Services



| [pic] |COUNTY OF DANE |

| |DEPARTMENT OF ADMINISTRATION |

| |EMPLOYEE RELATIONS DIVISION |

| |210 Martin Luther King, Jr. Boulevard, Room 418 |

| |Madison, Wisconsin 53703 |

| |Phone: 608/266-4125 ( Fax: 608/266-4409 |

| |Web Page: |

|TRAVIS MYREN | AMY UTZIG |

|Director of Administration |Human Resources Director |

| | |

January 25, 2013

Dear Disability Benefit Specialist Candidate:

Thank you for your expression of interest in this recruitment with Dane County.

The enclosed Achievement History Questionnaire is intended to give you the opportunity to describe your specific education, training and experience that would be relevant to this position.

The examination procedures will be as follows:

1) All competitors will be required to respond to the questions and return the

answers to our office (typewritten responses are encouraged.) Please be

specific and factual in the information you provide.

2) An impartial review panel who know the requirements of this position will

be convened to evaluate and grade all responses to the questions.

3) Those applicants receiving the highest exam scores will be invited to participate further in the process.

It is our belief that by providing competitors with written guidelines for describing their training and experience related to the demands of this position we can obtain a better assessment of each applicant’s relevant qualifications.

If you wish to be considered your completed application, your answers to the enclosed questions and signed certificate must be returned to the Employee Relations Division, Room 418 City-County Building, 210 Martin Luther King Jr. Blvd., Madison, WI 53703, by 4:30 p.m., Friday, February 8, 2013. Sorry, late examination materials will not be accepted.

Jean Fillner – Human Resources Specialist

Attachments

|Print or type your name: | |

Last four digits of your social security number: ____________________

Instructions: Please insert your name above and sign the certificate provided below for your answers to be considered. Answer the following questions in a concise and well organized manner, attaching your responses to these pages. Limit your responses to two pages per question using Arial font type, 11 font size. Please provide the last four digits of your Social Security Number in the upper-right-hand corner of each page of your responses to the questions. Do NOT include your name anywhere on the sheets containing your responses. In your answers, provide only specific relevant responses, including any information that may duplicate what you provided with your application for this position. It is important that each of your responses provides applicable or pertinent identifying information, such as job titles, employer names, time periods, etc. PLEASE NOTE: Graders will not have access to you application or resume during the grading process. Since being able to communicate effectively in writing is an important element of this position, your writing ability will also be evaluated. Typewritten responses are suggested.

CERTIFICATE

I certify that I prepared my responses without assistance other than typing. (If you are successful in reaching the employment selection interview stage, you will be asked background questions regarding one or more of your responses to this examination.) I further certify that to the best of my knowledge, the experience and/or training I specified in my attached responses are true and correct, and can be independently verified. I understand that any falsification of this certificate can be grounds for removal from the eligibles list or discharge from County Service.

| | | |

|Your Signature |Date Signed |

Dane County Department of Human Services

Aging and Disability Resource Center - Disability Benefit Specialist

Achievement History Questionnaire

Question One

This position will work very closely with adults ages 18 to 59 with a disability to offer information, advice, and assistance related to public benefits and services. Please describe your experience in working with adults in this capacity. Please be specific in describing your knowledge of public benefits and services to include Medicare, Social Security, Medicaid, health care financing, housing, and other financial and consumer concerns related to this population.

Question Two

This position will advocate on behalf of adults ages 18 to 59 with a disability when there are adverse decisions regarding public benefits. Please provide examples of how you advocated for this population – what was the situation, how did you handle it, what was the outcome. Please describe your experiences working with supervisory attorneys in advocating for these adults.

Question Three

This position will require networking with other related agencies and resources for the purpose of obtaining current information on programs, and of establishing effective working relationships. Please be specific in describing your experience working with related agencies.

Question Four

This position will require working together as a team on the intakes and referrals received; both with the other disability benefit specialists at the Aging & Disability Resource Center (ADRC), and with additional staff at the ADRC. Please describe your experience working as a member of a team, while handling an individual caseload.

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