Eligibility and Retention Specialist

Community Memorial Healthcare•San Buenaventura (Ventura), CA

13h•$25 - $30•Onsite

About The Position

Community Memorial Healthcare (CMH) is seeking a full-time Eligibility and Retention Specialist to support Gold Coast Health Plan members with Medi-Cal enrollment, re-enrollment, retention, and eligibility-related needs. This position focuses on assisting members ages 19–64 with maintaining healthcare coverage by providing outreach, education, navigation, and support in resolving enrollment barriers. The Eligibility and Retention Specialist serves as a liaison among patients, Gold Coast Health Plan, and healthcare providers at Community Memorial Healthcare to ensure continuous access to healthcare services. This role emphasizes proactive outreach, timely intervention, and member-centered support to reduce coverage disruptions and improve health outcomes. This position requires an individual who thrives in a dynamic environment, possesses strong customer service and problem-solving skills, and is passionate about helping vulnerable populations access and maintain healthcare coverage. This is a grant-funded position with a one-year term and the possibility of extension based on funding availability and program needs. This is a grant funded position from June 2026 to June 2027

Requirements

High School Diploma or equivalent (GED)
One (1) year of experience in healthcare, insurance enrollment, customer service, case management, community outreach, or a related field
Knowledge of Medi-Cal, managed care plans, or public assistance programs
Proficiency in Microsoft Office and electronic documentation systems
Valid California driver's license
Current and ongoing Motor Vehicle Report (MVR) considered insurable under CMH insurance coverage

Nice To Haves

Bilingual in Spanish and English
Strong organizational, communication, and documentation skills
Proficiency in electronic health records and data tracking systems
Experience reporting and analyzing data
Ability to manage multiple priorities and maintain professional composure in a fast-paced environment
Demonstrated ability to work collaboratively with multidisciplinary teams in primary care settings
Understanding of managed care principles, Medi-Cal eligibility, and medical terminology

Responsibilities

Support Gold Coast Health Plan members with Medi-Cal enrollment, re-enrollment, retention, and eligibility-related needs.
Assist members ages 19–64 with maintaining healthcare coverage by providing outreach, education, navigation, and support in resolving enrollment barriers.
Serve as a liaison among patients, Gold Coast Health Plan, and healthcare providers at Community Memorial Healthcare to ensure continuous access to healthcare services.
Emphasize proactive outreach, timely intervention, and member-centered support to reduce coverage disruptions and improve health outcomes.