Medicaid Enrollment Specialist

WelbeHealth, LLC.; Newark (NJ); On-site; USD 39,000 - 51,000; Full time

Benefits offered by this job

Medical insurance (Medical, Dental, V​

PTO - 17 days + holidays

401K savings + match

Advancement opportunities

Job summary

WelbeHealth is seeking a Medicaid Enrollment Specialist to support the Medi-Cal enrollment process within the MOE team. The role focuses on gathering documentation, submitting and appealing enrollments, and coordinating with DPSS to ensure timely and compliant processing.

The position requires a bachelor’s degree (or 5 years of relevant experience) and strong Spanish/English bilingual skills; travel to seniors’ homes and various community sites is expected.

Qualifications

• Bachelor’s degree preferred; five years of relevant Medicaid enrollment experience may be substituted.
• Bilingual Spanish/English strongly preferred.
• Minimum of three years working with the county DPSS on Medi-Cal enrollments and appeals.

Responsibilities

• Gather all necessary documentation to create, submit, and appeal Medicaid enrollments for prospective participants.
• Visit seniors at home to collect documentation and submit complete applications.
• Maintain relationships with DPSS to ensure seamless enrollment workflows and compliance with guidelines.
• Plan and conduct Medicaid enrollment events weekly at WelbeHealth centers and monthly at senior housing, hospitals, churches, and virtually.
• Demonstrate knowledge of Medicaid rules, processes, and appeals.

Skills

Bilingual Spanish/English

Medicaid enrollment experience

Documentation gathering

Education

Bachelor’s degree in relevant field

Job description

At WelbeHealth, our Outreach and Enrollment Team is the first touchpoint prospective participants have with us. A vital part of WelbeHealth’s PACE enrollment process is aiding those who qualify with the Medi-Cal Enrollment process.

The Medicaid Enrollment Specialist focuses on successfully enrolling prospective participants in Medicaid. The Medicaid Enrollment Specialist is a member of the Marketing, Outreach, and Enrollment (MOE) team and provides back-up and support to Outreach and Enrollment functions as assigned.

Essential Job Duties:

• Gather all necessary documentation to create, submit, doggedly pursue, and appeal Medicaid enrollments for prospective participants.
• Visit senior’s homes as needed to gather necessary documentation to submit complete applications
• Maintain a strong working relationship with the Department of Public and Social Services (DPSS) at the county to ensure seamless enrollment workflow, adhere to deadlines and ensure compliance with DHCS and CMS guidelines and policies (for example, marketing guidelines and denials policies)
• Create and conduct Medicaid enrollment events to attract prospective participants:
  • Every week in each of the WelbeHealth centers in territory
  • Monthly at senior housing, hospitals, senior centers, churches
  • Monthly virtual enrollment sessions
• Demonstrate in-depth knowledge of Medicaid rules, processes, practices, and options to enroll including but not limited to share of cost, spousal impoverishment protections, and appeals processes

Job Requirements:

• Bachelor’s degree in relevant field preferred, an additional five (5) years of relevant Medicaid enrollment experience may be substituted
• Bilingual (Spanish/English) strongly preferred
• Minimum of three (3) years of experience working directly with the county DPSS submitting, managing, and appealing Medi-Cal enrollments
• Demonstrated knowledge and experience with complex Medicaid enrollment case management

Benefits of Working at WelbeHealth: Apply your coding expertise in new ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for.

• Medical insurance coverage (Medical, Dental, Vision)
• Work/life balance - we mean it! 17 days of personal time off (PTO), 12 holidays observed annually, and sick time
• 401K savings + match
• Advancement opportunities - we’ve got a track record of hiring and promoting from within, meaning you can create your own path!
• And additional benefits

Compensation Offering

Compensation consists of base salary plus bonus. WelbeHealth offers a competitive total rewards package that includes a 401(k) match, comprehensive healthcare coverage, and a broad range of additional benefits. Actual compensation will be determined based on experience and relevant qualifications.

$28.23 - $37.27 USD

COVID-19 Vaccination Policy

At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all our employees and proof of vaccination, or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations.

Our Commitment to Diversity, Equity and Inclusion

At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.