Medicaid & Social Services Eligibility Navigator

PonosCare; Chicago (IL); On-site; USD 34,000 - 41,000; Full time

Job summary

Ponos Management, Inc. in Chicago, IL is seeking an Eligibility Specialist to help members access healthcare and social services.

You will guide them through eligibility processes for Medicaid and state benefit programs while coordinating resources across providers and community partners. You will interview members, collaborate with families and healthcare teams, and act as the single point of contact for determinations, applications, and referrals.

Qualifications

• High school diploma or equivalent; some college education preferred.
• Experience in a call center or healthcare benefits navigation.
• Strong knowledge of Illinois Medicaid, ABD, TANF, SSI.
• Excellent verbal and written communication skills.
• Strong organizational and multitasking abilities.
• Proficient with EHR and related software.
• Bilingual skills are a plus.

Responsibilities

• Act as liaison to ensure access to care and conduct home and social assessments.
• Create a safe, effective case management plan using available resources.
• Collaborate and communicate with members, families, and providers.
• Initiate referrals for social services and assist with eligibility processes with DHS.
• Communicate health information to stakeholders for coordinated care.
• Advocate for patients and families with the healthcare team.
• Document thoroughly in the member's health record.
• Educate on LTSS/SSI and track eligibility within state programs.
• Interact with DHS for application processes.

Skills

Call center experience

Healthcare benefits navigation

Communication skills

Organizational multitasking

Independent work

Team collaboration

Bilingual (plus)

Education

High school diploma or equivalent

Some college education preferred

Tools

EHR software

Job description

Ponos Management, Inc. in Chicago, IL is seeking an Eligibility Specialist to help members access healthcare and social services.

You will guide them through eligibility processes for Medicaid and state benefit programs while coordinating resources across providers and community partners. You will interview members, collaborate with families and healthcare teams, and act as the single point of contact for determinations, applications, and referrals.