Medi-Cal Assessment Coordinator (52121)

WestCare Inc; Fresno (CA); On-site; USD 74,500,608 - 85,962,240; Full time

Job summary

WestCare Foundation in Fresno is seeking a Medi-Cal Assessment Coordinator to ensure timely assessment, enrollment assistance, and connection to Medi-Cal and other healthcare benefits for participants reentering the community.

The role acts as a liaison among participants, MCPs, CDCR, and community providers to ensure continuity of medical and behavioral health services upon release, with duties including assessments, care planning, and enrollment support.

Qualifications

• Minimum two years of Medi-Cal eligibility or healthcare navigation experience.
• Bachelor’s degree in Social Work, Public Health, Healthcare Administration, Counseling or related field strongly preferred.
• High school diploma or equivalent required.
• Valid driver’s license and ability to obtain WestCare vehicle insurance.

Responsibilities

• Conduct comprehensive assessments of participants' healthcare, behavioral health, and Medi-Cal eligibility needs.
• Develop healthcare access plans integrating with individual service plans.
• Coordinate access to medical, behavioral health, and other healthcare services.
• Assist participants with Medi-Cal enrollment, reinstatement, renewal, and eligibility verification.
• Coordinate Managed Care Plan selection, primary care assignment, and referrals.
• Monitor enrollment status and address barriers to timely care.
• Serve as liaison among participants, CDCR, MCPs, County Behavioral Health and partners.
• Maintain documentation of assessments, referrals, enrollment activities, and progress.

Skills

Interpersonal skills

Written communication

Verbal communication

Professional appearance

Education

High School Diploma

Bachelor’s degree strongly preferred

Tools

CPR Certification

First Aid Certification

Job description

Job Details

Job Location: Fresno - 1850 N Gateway Blvd - Fresno, CA 93727

Position Type: Full Time

Education Level: High School

Salary Range: $26.00 - $30.00 Hourly

POSITION SUMMARY

The Medi-Cal Assessment Coordinator is responsible for ensuring that participants enrolled in the program receive timely assessment, enrollment assistance, and connection to Medi-Cal and other healthcare benefits necessary to support successful community reentry. This position serves as the liaison between participants, Managed Care Plans (MCPs), County Behavioral Health, healthcare providers, correctional partners, and community agencies to facilitate continuity of medical and behavioral health services upon release from incarceration. Other duties may be assigned as needed.

ESSENTIAL JOB FUNCTIONS

• Conduct comprehensive assessments to identify participants' healthcare, behavioral health, and Medi-Cal eligibility needs.
• Develop healthcare access plans that support successful community reentry and integrate with individualized service plans.
• Coordinate access to medical, behavioral health, substance use disorder treatment, and other healthcare services based on participant needs.
• Assist participants with Medi-Cal enrollment, reinstatement, renewal, and eligibility verification.
• Coordinate Managed Care Plan selection, primary care assignment, and referrals to appropriate healthcare providers.
• Monitor enrollment status and resolve barriers that may delay access to healthcare services.
• Serve as the liaison between participants, CDCR staff, Managed Care Plans, County Behavioral Health, healthcare providers, and community partners to ensure continuity of care.
• Participate in multidisciplinary case reviews and collaborate with program staff to support participant treatment and reentry goals.
• Maintain timely, accurate, and complete documentation of assessments, referrals, enrollment activities, and participant progress in accordance with CDCR, Medi-Cal, HIPAA, and organizational requirements.
• Assist with program reporting, quality assurance activities, and contract compliance efforts.
• Educate participants on available healthcare benefits, preventive care, and community resources to promote long-term health and self-sufficiency.
• Advocate for participants by identifying and addressing barriers to healthcare access and service engagement.
• Must Embrace and embody the mission, vision, guiding principles, clinical vision, and goals of WestCare Foundation;
• Perform all other duties as assigned.

QUALIFICATIONS

ESSENTIAL QUALIFICATIONS

To perform this job successfully, an individual must be able to perform the duties and responsibilities satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.

Experience and Competencies

• Experience working with justice-involved populations preferred.
• Experience working within behavioral health or substance use treatment settings preferred.
• Experience coordinating healthcare services across multiple systems strongly preferred.
• Strong interpersonal and motivational engagement skills.
• Ability to maintain professional boundaries in correctional and community-based settings.
• Excellent written and verbal communication skills.
• Professional appearance and demeanor.
• Ability to obtain and maintain clearance from California Department of Corrections and Rehabilitation (CDCR).
• Valid driver’s license and ability to obtain and maintain WestCare’s vehicle insurance is required.
• CPR Certification, First Aid Certification, and an annual Tuberculosis test.
• During your tenure with WestCare there may be new requirements, including, but not limited to vaccinations that are issued by local, State, Federal, and/or Funders that WestCare may have to comply with; if this occurs Human Resources or appropriate personnel will inform you.

EDUCATION and/or EXPERIENCE

• Minimum of two (2) years of experience in Medi-Cal eligibility, healthcare navigation, benefits coordination, case management, behavioral health, or community health.
• Bachelor’s degree in Social Work, Public Health, Healthcare Administration, Counseling, or related field is strongly preferred.
• Highschool diploma or its’ equivalent is required.

LICENSURE/CERTIFICATION

Not applicable for this position.

WORKING CONDITIONS

• Office and/or community-based setting.
• Frequent interaction with justice-involved individuals.
• Regular coordination with parole offices and community providers.
• Local travel required.

ESSENTIAL PHYSICAL AND MENTAL DEMANDS OF THE JOB

The employee must be able to perform the following essential duties and activities with or without accommodation:

PHYSICAL DEMANDS

• Requires mobility and physical activity: Having an adequate range of body motion and mobility to work in an office, residential, or outdoor environment including standing and walking (even and uneven surfaces), sitting for extended periods of time, bending, twisting, reaching, balancing, occasional lifting and carrying of up to 25 pounds. Use of computer and telephone systems is required which includes coordination of eye and hand, and fine manipulation by the hands (typing, writing, and working with files). Requires the ability to defend oneself and clients in physically abusive situations using approved physical de‑escalation techniques.
• Requires talking: Expressing or exchanging ideas by means of the spoken word. Talking is required to impart oral information to employees, clients, patients, and the public, and in those activities in which the employee is required to convey detailed or important spoken instructions to others accurately, loudly, or quickly.
• Requires hearing: Hearing is required to receive and communicate detailed information through oral communication.
• Requires seeing: Clarity of vision at 20 inches or less and at distance. This factor is required to complete paperwork for many of the employee’s essential job functions and to observe client behavior and activities in and out of the facility.
• The normal work routine involves no exposure to human blood, body fluids or tissues. However, exposure or potential exposure may be required as a condition of employment. Appropriate personal protective equipment will be readily available to every employee.

MENTAL DEMANDS

• Requires the ability to collect and analyze complex numerical and written data and verbal information to reach logical conclusions.
• Requires the ability to work and cooperate with clients, co‑workers, managers, the public and employees at all levels to exchange ideas, information, instructions, and opinions.
• Requires the ability to work under stress and in emotionally charged settings.
• The ability to defend oneself and clients in mentally/verbally abusive situations using approved mental/verbal de‑escalation techniques.