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Medi-caid Specialist

myPlaceHealth · 30+ days ago
Negotiable
Full-time
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Are you passionate about making a difference in the lives of underserved seniors in Los Angeles County? We're looking for a compassionate and dedicated Medicaid Specialist to join our team and play a pivotal role in helping frail seniors access the care and support they need. In this role, you'll have the rewarding opportunity to guide seniors through the Medicaid and Medicare application and renewal process, helping them stay in their homes and live independently for as long as possible. If you're ready to bring your expertise and heart to a mission-driven team, we’d love to hear from you!

What does success look like as a Medicaid Specialist?

  • Medicaid applications: initiate assist, and manage Medicaid applications for prospective participants, ensuring timely and accurate completion of the process, completing all necessary paperwork for Medicaid re-determination or new applications, offering guidance through complex processes.
  • Home Visits: Conduct home visits to assist participants with completing the Medi-Cal application process, providing a supportive and hands-on approach.
  • Documentation: Maintain accurate documentation and record all participant enrollment information in CRM software, ensuring data integrity and compliance with internal procedures.
  • Adherence to regulations and policy: Adhere strictly to DHCS and CMS regulations and policies, particularly regarding marketing practices for the PACE Program, ensuring ethical standards are upheld.
  • Cross departmental collaboration: Collaborate with the Finance Department to prepare various reports for data analysis, supporting financial transparency and decision-making. Validate Medicaid payment, ensuring accurate and timely payment processing
  • Case Management: Monitor and maintain participants’ Medicaid eligibility, including managing the recertification process for Medi-Cal, ensuring no lapses in coverage.
  • Growth Department support: Assist the Enrollment and Outreach Specialists as needed, offering additional support during high-volume periods or special initiatives.
  • Be a beacon for the communities: Provide community resources to prospective participants and their families/caregivers, helping them access relevant support services and information.
  • Government agency collaboration: Collaborate with or contact county/state government specialist to ensure the submission of required documentation or to obtain additional information when needed.
  • Contribute to the big picture: Take on additional responsibilities as needed to support the success of myPlace Health’s mission

What does an ideal candidate look like?

  • Medi-Cal & Social Security Expertise: Strong knowledge of California's Medi-Cal system and the Social Security process.
  • State/County Eligibility Experience: Proven experience working with State and County eligibility workers.
  • Community Resources Knowledge: Extensive understanding of available community resources.
  • Experience with Frail Elderly: Prior experience working with frail older adults in a care setting.
  • Education: High School Diploma required.
  • Bilingual Skills Preferred: Spanish, Cantonese, Mandarin, or Vietnamese language skills are a plus.
  • Driver’s Documentation: Proof of a valid driver’s license, personal transportation, good driving record, and state-required auto insurance.

Last updated on Oct 4, 2024

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