Medicaid Eligibility Navigator for Elder Care & PACE

Blue Ridge Care; Winchester (VA); On-site; USD 52,000 - 76,000; Full time

Benefits offered by this job

Competitive Pay

PTO & Volunteer Time

Health Benefits

Tuition Reimbursement

Peer Support & Mentorship

Thrift Shop Discount

Growth Opportunities

Job summary

Blue Ridge Care seeks a compassionate Medicaid Specialist to guide participants through Medicaid eligibility, enrollment, and continued coverage. You will ensure timely access to services, maintain regulatory compliance, and collaborate with interdisciplinary teams.

As a nonprofit provider, we support older adults and families across hospice, serious illness care, and related services, with emphasis on dignity and quality of life.

Qualifications

• Minimum 2 years of Medicaid eligibility, enrollment, or benefits coordination experience.
• Knowledge of CMS and state Medicaid regulations for PACE.
• Proficiency in Microsoft Office and enrollment/EHR systems.

Responsibilities

• Screen prospective PACE participants for Medicaid eligibility (full, partial, or spend-down).
• Prepare, submit, and track Medicaid applications, renewals, and recertifications.
• Coordinate eligibility determinations with state/local DSS or Medicaid agencies.

Skills

Medicaid rules

Eligibility & enrollment processing

Documentation & HIPAA

Education

High School diploma or GED

Associate’s or Bachelor’s degree in related field

Tools

Enrollment/EHR systems

Job description

Blue Ridge Care seeks a compassionate Medicaid Specialist to guide participants through Medicaid eligibility, enrollment, and continued coverage. You will ensure timely access to services, maintain regulatory compliance, and collaborate with interdisciplinary teams.

As a nonprofit provider, we support older adults and families across hospice, serious illness care, and related services, with emphasis on dignity and quality of life.