Medicaid Waiver Case Manager - Remote/Hybrid Eligible

Texas Health and Human Services; Grand Prairie (TX); On-site; USD 33,000 - 41,000; Full time

Benefits offered by this job

100% Health insurance

Defined benefit pension

Generous time off

Career advancement opportunities

Job summary

Texas Health and Human Services Commission in Grand Prairie, TX seeks a Community Care Worker III to support Medicaid waiver programs and manage eligibility and enrollment for STAR Kids and HCBS services. The role involves coordinating with MCOs, MEPD, and other HHSC departments to ensure smooth transitions for applicants and members.

Responsibilities include processing eligibility decisions, coordinating enrollments, handling age-out transitions, and facilitating fair hearings when needed, with

Qualifications

• High School Diploma or GED required.
• Prefer experience with case management.
• Prefer experience with time management.
• Prefer experience with complex policy interpretation requiring good judgement.

Responsibilities

• Develop, coordinate, and explain waiver programs to applicants and members.
• Authorize or deny waiver services and send approval/denial notices.
• Validate eligibility in TIERS, SASO, and LTCOP.
• Coordinate with MEPD staff for enrollment in Medicaid.
• Assist denied Medicaid waiver members to file a fair hearing.
• Handle reporting, monitoring, and resolving enrollment errors.

Skills

Medicaid waiver programs policies

Effective communication

Public service delivery

Time management

Customer service

Policy interpretation

Education

High School Diploma or GED

Tools

Outlook

Excel

Word

TIERS

SASO

LTCOP

Job description

Texas Health and Human Services Commission in Grand Prairie, TX seeks a Community Care Worker III to support Medicaid waiver programs and manage eligibility and enrollment for STAR Kids and HCBS services. The role involves coordinating with MCOs, MEPD, and other HHSC departments to ensure smooth transitions for applicants and members.

Responsibilities include processing eligibility decisions, coordinating enrollments, handling age-out transitions, and facilitating fair hearings when needed, with