Medicaid Eligibility Lead — Enrollment & Compliance

InnovAge Holding Corp.; Charlottesville (VA); On-site; USD 52,000 - 65,000; Full time

Job summary

InnovAge Holding Corp. seeks an Eligibility and Financial Determination Lead to work with Enrollment Representatives reviewing Medicaid applications for Innovage PACE applicants, ensuring timely review and exceptional service.

Responsibilities include staff training, application reviews, and maintaining tracking systems; ensuring Medicaid compliance across state rules, with collaboration across county agencies and internal teams.

Qualifications

• 4+ years total related experience required.
• 2+ years with CBMS Medicaid system and knowledge of Medicaid benefits.
• 2+ years working with the frail or elderly population.

Responsibilities

• Train new staff on the Specialists team and support the supervisor in their absence.
• Review applications from Enrollment Representatives and obtain necessary documentation for Medicaid approval.
• Maintain tracking of applications from submission to approval, including private pay transitions.
• Ensure compliance with State Medicaid rules and regulations; stay current on updates.
• Collaborate with Accounts Receivable and supervisor on case issues and training needs.
• Provide leadership to Eligibility Specialists to maintain morale and teamwork.
• Respond promptly to 10-day notices and denial notices on new applications.

Skills

4+ yrs total related experience

2+ yrs CBMS Medicaid

2+ yrs working with elderly

Education

Bachelor's degree

Job description

InnovAge Holding Corp. seeks an Eligibility and Financial Determination Lead to work with Enrollment Representatives reviewing Medicaid applications for Innovage PACE applicants, ensuring timely review and exceptional service.

Responsibilities include staff training, application reviews, and maintaining tracking systems; ensuring Medicaid compliance across state rules, with collaboration across county agencies and internal teams.