Medicaid Support Specialist (Remote)

Careforth; Oregon; Hybrid; USD 27,000 - 38,000; Full time

Benefits offered by this job

Remote-first culture

Wellness program

Flexible schedules

Job summary

Careforth, a Boston-based caregiver support company, is seeking a Medicaid Support Specialist to guide families through Medicaid and Waiver enrollment and sustain access to Careforth programs. You will work with enrollment teams, case managers, and caregivers to ensure appropriate coverage and ongoing support.

Requirements include a Bachelor’s in health care or related field, 4–6 years in health care, 2+ years Medicaid experience, and strong communication skills.

Qualifications

• Bachelor's degree required or equivalent work experience.
• 4–6 years in health care.
• 2+ years Medicaid or government program experience.
• Strong communication and interpersonal skills.

Responsibilities

• Develop strong relationships with state Medicaid agency professionals, access agencies, and case managers responsible for Medicaid and Waiver applications; help Careforth become a preferred partner to work with.
• Review Medicaid and Waiver applications to ensure eligibility for Careforth programs and assess caregiver suitability; provide alternative resources for ineligible families as needed.
• Collaborate with enrollment teams, external case managers, and caregivers to help families obtain appropriate coverage for Careforth programs.
• Stay up-to-date with state and federal Medicaid/waiver regulations; research new programs for eligibility requirements as needed.
• Document key processes and support workflow development; review and update case notes in the case management system as needed.
• Provide ongoing determination and eligibility support; resolve coverage loss events.
• Provide insights, data and reporting to support initiatives with Growth leadership.
• Perform other duties as assigned

Skills

Communication skills

Relationship building

Bilingual preferred

Education

Bachelor's degree in health care or related discipline

Tools

Microsoft Office

Job description

About Us

A pioneer in the caregiving space, Careforth supports family caregivers across the United States to confidently care for their loved ones at home. Through a combination of in-person home visits, remote coaching and our proprietary digital collaboration app, we provide caregivers with support, guidance, confidence, and connection to resources they need. The Caregivers and families we support stay with Careforth for many years, building lasting relationships along the way.

Join us today and live our values: lead with heart, cultivate trust, go beyond.

Position Summary

The Medicaid Support Specialist (MSS) supports consumers and family caregivers in navigating Medicaid and Waiver enrollment as well as provides on-going eligibility support to ensure the continuity of services at Careforth. This individual will use their experience and expertise with state Medicaid programs and waiver programs to provide guidance both internally and externally to help qualified individuals gain access to Careforth programs and services.

What You Will Do

• Develop strong relationships and good rapport with state Medicaid agency professionals, Access Agencies, and case managers responsible for Medicaid and Waiver applications; Help Careforth become a preferred partner to work with
• Review Medicaid and Waiver applications to ensure consumers are eligible for Careforth programs and caregivers meet state and Careforth requirements; Provide alternative resources for ineligible families as needed
• Work collaboratively with Careforth’s enrollment teams, external case managers, and caregivers to assist families in obtaining the appropriate coverage to participate in Careforth programs
• Stay abreast of state/federal regulations and trends related to Medicaid programs and waivers that support caregiver coaching and Structured Family Caregiving (SFC); perform initial research into new programs for state and federal requirements for eligibility information as needed
• Capture and document key processes associated with successful Medicaid and waiver approval to develop and support workflow and staff education, as well as provide oversight of applications through approval; Review and update case notes within case management system as needed using established system protocols.
• Provide consumers with on-going determination and eligibility support; resolve loss of coverage events
• Provide insights, data and reporting to support initiatives in key Careforth departments in collaboration with Growth leadership
• Perform other duties as assigned

What You Will Bring

• Bachelor’s degree in health care or related discipline or equivalent work experience
• 4-6 years of experience in health care
• 2+ years of direct experience with Medicaid and other federal and/or state government programs
• Proven success developing professional and collaborative relationships with diverse groups
• Tech savvy with ability to toggle between multiple systems and programs; Strong MS Office skills required
• Outstanding customer service; strong oral and written communication skills
• Bi-lingual skills preferred

You'll Benefit From

At Careforth your well-being matters. With flexible schedules, a remote-first culture, and a nationally recognized wellness program, our benefits are designed to help you thrive, both professionally and personally. Discover how we invest in you:

careers/#benefits

The pay range for this position is $19.50 - $27.30. The actual wage offered may be lower or higher depending on budget and candidate experience, knowledge, skills, qualifications, and geographic location.

#LI-Remote

Join Our Award Winning Team

Founded in Boston, Careforth's caregiver programs and services improve health outcomes, keeping care at home longer. Additionally, our programs provide financial benefit to caregivers and cost savings to state agencies and health plans. At Careforth, we understand the challenges of caregiving and are committed to supporting family caregivers at every turn. Caregivers play a critical role in the future of healthcare—and so can you.

Careforth is an Equal Opportunity Employer

Careforth supports families with diverse backgrounds and as an equal opportunity employer, we seek employees who reflect the diverse population we serve. Careforth complies with all applicable laws concerning hiring and employment practices and is firmly committed to fostering and maintaining a workplace free from discrimination. We pledge to hire, train, and promote our employees without regard to race, religion, gender, gender identity, genetic information, age, national origin, sexual orientation, disability, veteran status, or any other category protected by applicable law.

Careforth strives to create experiences that are accessible and welcoming to everyone, including making www.careforth.com and the careers site accessible to any and all users. If you would like to contact us regarding the company’s diversity, equity and inclusion initiatives, inquire about a specific accessibility need or the accessibility of our website, or if you need assistance completing an application process, please contact People & Culture at .