Enrollment Specialist

Element Care•Methuen, MA

About The Position

The Enrollment Specialist is an integral member of the PACE enrollment team, coordinating and adapting the enrollment process to meet prospective participants’ individual needs and help achieve census goals. The role serves as a liaison among prospective participants and caregivers, the enrollment team, PACE interdisciplinary teams (IDTs), referral sources, and community providers to support efficient, timely enrollment. Work is based in the office and in the community, including prospective participants’ homes. The position is full time, Monday through Friday, 8:00 a.m. to 4:00 p.m., with no weekend or holiday hours. The Enrollment Specialist explains the PACE model, evaluates prospective participants’ needs and health status, coordinates eligibility and financial documentation, and supports participants through orientation and completion of enrollment paperwork. The role also maintains referral data, provides updates to referral sources, and builds relationships with community health and human services agencies. It exercises significant independent judgment in determining how to accomplish work and achieve objectives.

Requirements

Associate degree required.
At least one year of experience working with seniors and their caregivers in a healthcare and/or mental health setting.
Advanced computer skills, including Microsoft Office and Customer Relationship Management software.
Ability to communicate effectively and build trust with licensed medical personnel.
Ability to respond appropriately to complex clinical situations in a variety of settings.
Strong knowledge of medical terminology and medical/psychiatric diagnoses.
Experience working competently and comfortably with individuals from diverse socio-cultural backgrounds.
Ability to assess conflicts from multiple perspectives and find a win-win resolution.
Skills in customer relations and prioritization in a challenging, multitasking environment.
COVID vaccine required.

Nice To Haves

Bachelor’s degree in social work, sociology, psychology, business, public health, or a related field.
Spanish speaking.

Responsibilities

Conduct initial appointments to explain the PACE model to prospective enrollees and their caregivers.
Ensure prospective participants meet eligibility criteria in accordance with PACE enrollment regulations.
Use a strength-based approach to evaluate prospective participants’ current needs and health status.
Communicate enrollment status and progress to the enrollment team, IDT, and other pertinent parties.
Collaborate with other departments to obtain financial documents from prospective participants for submission.
Participate in weekly Enrollment Team meetings to discuss challenging referrals and barriers or conflicts.
Facilitate prospective participants’ visits and tours of PACE Health Centers and coordinate meetings with IDT members.
Manage the enrollment process, including appropriate orientation to PACE sites and completion and submission of documents.
Follow up with referral sources regarding the status of referred prospective participants.
Compile and maintain accurate data on referrals and prospective participants in CRM software.
Develop and maintain collaborative relationships with health and human services agencies and community providers to enhance consumer access to resources.
Communicate regularly with referral sources to build confidence in the PACE enrollment process and optimize the flow of new referrals.
Exercise independent judgment to determine effective methods for accomplishing work and achieving objectives.