Medicaid Specialist — PACE Care Navigator & Advocate

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

Benefits offered by this job

Competitive Pay

PTO & Paid Volunteer Time

Comprehensive Health Benefits

Tuition Reimbursement & Scholarships

Peer Support & Mentorship

30% Thrift Shop Discount

Growth Opportunities aligned with our

Job summary

Blue Ridge Care is seeking a compassionate Medicaid Specialist to guide aging participants through eligibility, enrollment, and ongoing coverage within our PACE program. You will ensure timely access to services, maintain regulatory compliance, and coordinate with interdisciplinary teams to support enrollment and care planning.

You’ll educate participants and caregivers on benefits, collect required documentation, and partner with DSS, IDT, and finance to prevent gaps in coverage while

Qualifications

• High School diploma or GED required.
• Associate’s or Bachelor’s degree preferred.
• Minimum 2 years of Medicaid eligibility, enrollment, or benefits coordination experience.
• PACE, long-term care Medicaid, managed care, or waiver experience strongly preferred.
• Strong knowledge of Medicaid rules and application processes.

Responsibilities

• Screen participants for Medicaid eligibility (full, partial, or spend-down).
• Prepare, submit, and track applications, renewals, and recertifications.
• Coordinate eligibility determinations with state/local DSS or Medicaid agencies.
• Monitor application timelines to ensure enrollment compliance and prevent coverage gaps.
• Maintain active oversight of participant eligibility, renewals, and benefit changes.
• Educate participants and caregivers about Medicaid benefits, renewals, and requirements.

Skills

Medicaid eligibility

Enrollment coordination

HIPAA compliance

Microsoft Office

EHR systems

Bilingual

Interdisciplinary collaboration

Education

High School diploma or GED

Associate’s or Bachelor’s degree

Tools

Enrollment/EHR systems

CMS portals

Microsoft Office

State Medicaid portals

Job description

Blue Ridge Care is seeking a compassionate Medicaid Specialist to guide aging participants through eligibility, enrollment, and ongoing coverage within our PACE program. You will ensure timely access to services, maintain regulatory compliance, and coordinate with interdisciplinary teams to support enrollment and care planning.

You’ll educate participants and caregivers on benefits, collect required documentation, and partner with DSS, IDT, and finance to prevent gaps in coverage while