Medicaid Support Specialist (Remote)

Careforth•Worthington, OH

21h•Remote

About The Position

The Medicaid Support Specialist (MSS) supports consumers and family caregivers as they navigate Medicaid and Waiver enrollment and receive ongoing eligibility support to maintain continuity of services at Careforth. The specialist applies knowledge of state Medicaid and waiver programs to guide internal teams and external partners so qualified individuals can access Careforth programs and services. This remote role works with state Medicaid agencies, Access Agencies, case managers, enrollment teams, consumers, and caregivers. The listed pay range is $19.50–$27.30; the actual wage may vary based on budget, candidate qualifications and experience, and geographic location.

Requirements

Bachelor’s degree in health care or a related discipline, or equivalent work experience.
4–6 years of experience in health care.
At least 2 years of direct experience with Medicaid and other federal and/or state government programs.
Proven success developing professional and collaborative relationships with diverse groups.
Tech savvy, with the ability to work across multiple systems and programs.
Strong Microsoft Office skills.
Outstanding customer service skills.
Strong oral and written communication skills.

Nice To Haves

Bilingual skills preferred.

Responsibilities

Build strong relationships with professionals at state Medicaid agencies, Access Agencies, and with case managers who handle Medicaid and Waiver applications, helping Careforth become a preferred partner.
Review Medicaid and Waiver applications to verify consumer eligibility for Careforth programs and whether caregivers meet state and Careforth requirements; identify alternative resources for ineligible families as needed.
Work with Careforth enrollment teams, external case managers, and caregivers to help families obtain appropriate coverage for participation in Careforth programs.
Monitor state and federal regulations and trends related to Medicaid and waiver programs that support caregiver coaching and Structured Family Caregiving (SFC); research eligibility requirements for new programs as needed.
Document processes associated with successful Medicaid and waiver approvals to support workflows and staff education, and oversee applications through approval.
Review and update case notes in the case management system according to established protocols.
Provide ongoing determination and eligibility support to consumers and resolve loss-of-coverage events.
Provide insights, data, and reporting to support initiatives in key Careforth departments in collaboration with Growth leadership.
Perform other duties as assigned.