Medicaid Enrollment Specialist

WelbeHealth • Newark, NJ

3d • Onsite

About The Position

At WelbeHealth, our Outreach and Enrollment Team is the first touchpoint prospective participants have with us. A vital part of WelbeHealth’s PACE enrollment process is aiding those who qualify with the Medi-Cal Enrollment process. The Medicaid Enrollment Specialist focuses on successfully enrolling prospective participants in Medicaid. The Medicaid Enrollment Specialist is a member of the Marketing, Outreach, and Enrollment (MOE) team and provides back-up and support to Outreach and Enrollment functions as assigned.

Requirements

• Minimum of three (3) years of experience working directly with the county DPSS submitting, managing, and appealing Medi-Cal enrollments
• Demonstrated knowledge and experience with complex Medicaid enrollment case management

Nice To Haves

• Bachelor’s degree in relevant field preferred, an additional five (5) years of relevant Medicaid enrollment experience may be substituted
• Bilingual (Spanish/English) strongly preferred

Responsibilities

• Gather all necessary documentation to create, submit, doggedly pursue, and appeal Medicaid enrollments for prospective participants.
• Visit senior’s homes as needed to gather necessary documentation to submit complete applications
• Maintain a strong working relationship with the Department of Public and Social Services (DPSS) at the county to ensure seamless enrollment workflow, adhere to deadlines and ensure compliance with DHCS and CMS guidelines and policies (for example, marketing guidelines and denials policies)
• Create and conduct Medicaid enrollment events to attract prospective participants: Every week in each of the WelbeHealth centers in territory Monthly at senior housing, hospitals, senior centers, churches Monthly virtual enrollment sessions
• Demonstrate in-depth knowledge of Medicaid rules, processes, practices, and options to enroll including but not limited to share of cost, spousal impoverishment protections, and appeals processes

Benefits

• Medical insurance coverage (Medical, Dental, Vision)
• 17 days of personal time off (PTO), 12 holidays observed annually, and sick time
• 401K savings + match
• Advancement opportunities
• Competitive total rewards package

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree