Flagstaff Medical Eligibility Specialist

Arizona State Government; Flagstaff (AZ); Hybrid; USD 51,000 - 65,000; Full time

Job summary

An established industry player is seeking a dedicated Medical Eligibility Specialist to determine eligibility for long-term care services. This role involves conducting interviews, managing caseloads, and collaborating with various agencies. The ideal candidate will possess strong communication and relationship-building skills, with a requirement for bilingual fluency in Navajo for specific locations. This position offers opportunities for remote work based on performance and department needs, alongside a comprehensive benefits package including holidays, paid leave, and retirement plans. Join a team that values community service and professional development.

Benefits

Holidays

Paid Leave

Parental Leave

Retirement Plans

Insurance

Loan Forgiveness

Transit Subsidies

Development Opportunities

Qualifications

• 3 years of social service case management experience required.
• Bilingual in Navajo is mandatory for Chinle office.

Responsibilities

• Conduct comprehensive pre-admission screenings and manage caseloads.
• Review medical records and communicate outcomes to applicants.

Skills

Prioritization

Communication

Relationship-Building

Documentation

Medical Assessment

Fluency in Navajo

Computer Proficiency

Adaptability

Education

Nursing Degree with Active Arizona RN License

Related Degree with 2 Years of Experience

Tools

HEAplus

Job description

Flagstaff Medical Eligibility Specialist

Division of Member and Provider Services (DMPS)

Location: 2717 North Fourth Street, Suite 130, Flagstaff, Arizona 86004

This position may offer remote work within Arizona, based on department needs and performance.

Salary and Review Date

Salary: $51,340 | Grade: 20 | First Resume Review: May 19, 2025

Job Summary

This role involves determining medical eligibility for the Arizona Long Term Care Services (ALTCS) program through face-to-face interviews and documentation. The specialist may also conduct financial eligibility interviews, complete applications, and verify eligibility factors. Bilingual fluency in Navajo is required for some offices.

Key Responsibilities

1. Drive to conduct comprehensive pre-admission screenings in various settings, explaining benefits and rights.
2. Manage caseloads, schedule and document interviews, and update case files in HEAplus.
3. Review medical records, gather data, and collaborate with other agencies and professionals.
4. Communicate outcomes to applicants and provide community resources as needed.

Knowledge, Skills & Abilities

Knowledge: Medical and psychosocial issues, regulations, community resources, and cultural influences.
Skills: Prioritization, communication, relationship-building, documentation, and medical assessment.
Abilities: Fluency in Navajo (for Chinle), understanding laws and regulations, computer proficiency, and adaptability to changing priorities.

Minimum Qualifications

3 years of social service case management experience, or nursing degree with active Arizona RN license, or a related degree with 2 years of experience. Navajo bilingualism required for Chinle office. Bilingual in Spanish preferred for other locations.

Pre-Employment Requirements

Background checks, driver’s license and driving record review, E-Verify completion, and possible travel. Valid driver’s license and insurance required if driving is essential.

Benefits

Includes holidays, paid leave, parental leave, retirement, insurance, loan forgiveness, transit subsidies, and development opportunities. Remote work options are available but at management discretion.

Retirement Plans

Lifetime pension through ASRS and voluntary deferred compensation options.

Contact

Disability accommodations available upon request. The Arizona State is an Equal Opportunity Employer.