Medi-Cal Eligibility Specialist

Requirements

• Minimum of three (3) years of experience working directly with the county DPSS submitting, managing, and appealing Medi-Cal eligibility and redeterminations
• Demonstrate in-depth knowledge of Medi-Cal rules, processes, practices, and options for Medi-Cal eligibility and redetermination
• Demonstrated knowledge and experience with complex Medi-Cal eligibility and redetermination case management
• Excellent verbal and written communication skills
• Willing to work weekends as necessary, particularly for community events
• Proof of medical clearance for communicable diseases, including a TB test
• Proof of all immunizations is up to date
• Proof of valid CA driver's license, personal transportation, good driving record and auto insurance as required by State law
• Bilingual (Spanish/English) strongly preferred
• A minimum of one year experience working with the frail or elderly
• Experience working with the Medicare and Medicaid populations and within a healthcare organization

Benefits

Additional Information

At Habitat Health, we envision a world where older adults experience an independent and joyful aging journey in the comfort of their homes, enabled by access to comprehensive health care. Habitat Health provides personalized, coordinated clinical and social care as well as health plan coverage through the Program of All-Inclusive Care for the Elderly ("PACE") in collaboration with our leading healthcare partners, including Kaiser Permanente. Habitat Health offers a fully integrated experience that brings more good days and a sense of belonging to participants and their caregivers. We build engaged, fulfilled care teams to deliver personalized care in our centers and in the home. And we support our partners with scalable solutions to meet the health care needs and costs of aging populations. Habitat Health is growing, and we're looking for new team members who wish to join our mission of redefining aging in place. To learn more, visit https://www.habitathealth.com . Role Scope : This is an opportunity for a highly motivated and detailed oriented individual that is responsible for supporting prospective participants and existing participants navigate Medi-Cal eligibility and redeterminations. This individual will work closely with Habitat Health's Outreach & Enrollment to support prospective participants apply for Medi-Cal eligibility, follow-up on application status, and answer questions that prospective participants may have. This individual will also work with Habitat Health's Health Plan team to help existing participants navigate redeterminations. This role requires a combination of excellent customer service skills, attention to detail, deep understanding of Medi-Cal eligibility and redetermination, and proficiency in managing and processing multiple Medi-Cal eligibility and redetermination applications. Partner with center staff, health plan, and outreach & enrollment to triage Medi-Cal status issues that affect PACE eligibility Track Medi-Cal application pipeline to inform Growth and Health Plan operations Gather all necessary documentation to create, submit, pursue, and appeal Medi-Cal eligibility for prospective participants and existing participants for re-eligibility / redetermination with Medi-Cal Visit senior's homes as needed to gather necessary documentation to submit complete applications and redeterminations Maintain a strong working relationship with the County and Local social service agencies (e.g., DPSS) to ensure seamless enrollment and re-eligibility workflow, adhere to deadlines and ensure compliance with DHCS and CMS guidelines and policies Create and conduct Medi-Cal eligibility events at Habitat Health Centers, with community partners, and virtual sessions.

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