Medicaid LTSS Care Coordinator — Remote Eligible

Texas Health and Human Services; El Paso (TX); Hybrid; USD 33,000 - 49,000; Full time

Benefits offered by this job

Health insurance

Pension plan

Paid time off

Career advancement opportunities

Job summary

Texas Health and Human Services Commission (HHSC) is seeking a Community Care Worker III to support LTSS Medicaid 1115 waiver programs in El Paso. You will work with case managers, MCOs, nursing facility staff, and MEPD to coordinate enrollment, waivers, and transitions.

Daily duties include eligibility validation, waiver enrollment, and tracking appeals, while maintaining compliance and service delivery standards in a dynamic environment.

Qualifications

• High School Diploma or GED required.
• Preferred experience with LTSS and Medicaid programs.
• Experience with CCSE, MCOs, and MEPD is a plus.
• Proficiency in Outlook, Excel, and Word.
• Knowledge of Medicaid 1115 waivers is beneficial.

Responsibilities

• Attends work on a regular and predictable schedule as per agency policy.
• Develop, coordinate, and explain Medicaid 1115 waiver programs and authorize/deny waivers.
• Perform interest list activities: confirm contacts, mail packets, track enrollments.
• Interpret policy and coordinate transitions from nursing homes to the community.
• Resolve obstacles by contacting appropriate staff and documenting reasons.
• Handle LTSS continuity issues for waiver members in transition or disenrollment.
• Assist waiver members who were denied services to file a fair hearing.
• Prepare reports to monitor program operations and resolve enrollment errors.

Skills

Medicaid 1115 waiver

Outlook

Excel

Word

TIERS

SAS

Communication

Multitasking

Time management

Problem solving

Education

High School Diploma or GED

Tools

Outlook

Excel

Word

TIERS

SAS

CSIL

Job description

Texas Health and Human Services Commission (HHSC) is seeking a Community Care Worker III to support LTSS Medicaid 1115 waiver programs in El Paso. You will work with case managers, MCOs, nursing facility staff, and MEPD to coordinate enrollment, waivers, and transitions.

Daily duties include eligibility validation, waiver enrollment, and tracking appeals, while maintaining compliance and service delivery standards in a dynamic environment.