Medicaid Eligibility Manager

🕒 6 dias atrás

🔔 Pennsylvania – Remoto

🔔 Pennsylvania – Remote

💵 $0 - $65.000 / ano

⏰ Tempo Integral

🟢 Júnior

👔 Gerente

🚫👨‍🎓 Sem graduação necessária

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• Aberta há 6 dias.
• As vagas desta empresa costumam ser preenchidas em 40 dias.

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One Senior Care

SiteLinkedInTodas as Vagas

201 - 500 funcionários

🏥 Saúde

📦 Logística

💼 Consultoria

Healthcare • Logistics • Consulting

A One Senior Care se dedica a melhorar a qualidade de vida de pessoas idosas, especialmente aquelas que vivem em áreas rurais e regiões com acesso limitado a serviços, oferecendo atendimento de saúde e serviços sociais abrangentes e centrados na pessoa. Sua missão é apoiar programas PACE por meio de soluções inovadoras e um atendimento excepcional, permitindo que os profissionais de cuidado se concentrem em oferecer assistência de qualidade e reduzindo os encargos administrativos. A One Senior Care promove parcerias entre líderes comunitários do PACE para colaborar em boas práticas, compartilhar recursos e melhorar os resultados do atendimento às pessoas idosas, contribuindo para que elas vivam de forma independente em suas próprias casas.

Descrição

• Manage the transition of Medicaid applications from intake teams to establish eligibility for newly enrolled Participants • Monitor eligibility for pending and presumptive enrollees and respond to county requests for information • Track and manage Medicaid renewals and revalidations using established workflows and timelines • Support the appeals process on behalf of Participants when needed • Coordinate with county offices and internal teams to ensure required documentation is received and submitted accurately • Respond timely to changes in participant Medicaid Status • Conduct ongoing monitoring of eligibility, including annual and situational redeterminations • Communicate with internal teams regarding eligibility status, renewal deadlines, documentation needs, and policy changes affecting access to services • Build and maintain professional relationships with county offices to support timely issue resolution • Work primarily independently at a steady, predictable pace while supporting internal teams and external partners

🎯 Requisitos

• High school diploma or equivalent required • Bachelor’s degree preferred • Knowledge of Medicaid, Medicare, and PACE eligibility regulations preferred • At least one year of experience working with the frail or elderly population, or willingness to complete extensive training • Experience using electronic records or case management systems is a plus • Highly detail-oriented with a strong focus on accuracy and consistency • Comfortable following clearly defined processes and procedures • Patient, conscientious, and able to double-check work to ensure quality results • Organized and dependable, with the ability to manage repetitive tasks effectively • Professional, polite, and service-oriented in all interactions • Able to work independently while collaborating as needed with internal partners • Ability to move intermittently throughout the workday • Ability to sit, stand, bend, and lift as needed • Must be able to drive a motor vehicle • Ability to travel locally and regionally, with occasional overnight travel • Successful completion of required background checks, health and safety screenings, and any clearances required for healthcare programs

🏖️ Benefícios

• 9 Paid Holidays • PTO starting at 3 weeks + 1 day per year (accrued from date of hire for full-time employees) • Medical, Dental, & Vision • Free Life and AD&D Insurance Plan • Health Savings and Flexible Spending Accounts • Short Term Disability Insurance • Group Voluntary Term Life Insurance for Employee, Spouses, and Dependents • Paid Parental Leave • Tuition Reimbursement and Paid Training Opportunities • Retirement Plan with company annual match • Mileage Reimbursement at annual IRS rate as applicable • Training, mentorship, and career development programs

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