PACE Eligibility Advocate: Medi-Cal & Medicare Access

Neighborhood Healthcare; Murrieta (CA); On-site; USD 37,000 - 52,000; Full time

Benefits offered by this job

Medical/Dental/Vision plans

Vacation time

Holidays (9) including floating days

Sick/Personal time

Volunteer Time Off

403b Retirement plan

Health and Wellness events

Job summary

Neighborhood Healthcare seeks an Eligibility Specialist to help participants access Medi-Cal/Medicare coverage for PACE services. This onsite role involves applying for coverage, assessing options, and coordinating renewals with DHCS, County, and CMS requirements.

The position requires a high school diploma or GED, 1 year of healthcare or customer service experience, and relevant certifications. Bilingual English/Spanish preferred, with a comprehensive benefits package and growth opportunities.

Qualifications

• High school diploma or GED required.
• CA DHCS PACE and Medi-Cal certification must be obtained within 60 days of hire.
• 1 year healthcare or customer service experience required.
• Valid driver's license and active auto insurance required.
• Bilingual English/Spanish preferred.
• Current Basic Life Support (BLS) certification required on hire and maintained.
• CPR and First Aid certifications required for all staff.

Responsibilities

• Assist individuals in applying for and retaining Medi-Cal and/or Medicare coverage.
• Assess and discuss coverage options with enrollees for best eligibility solutions.
• Submit applications timely per DHCS, County, and CMS expectations.
• Complete enrollment and eligibility reporting accurately.
• Ensure prompt follow-ups on assigned eligibility cases.
• Coordinate with PACE Social Services to resolve eligibility issues.
• Monitor Medi-Cal renewal processes and changes to accounts.
• Educate staff and participants on eligibility processes and updates.
• Assist with staff orientations and training.
• Accompany participants to external agencies as needed.
• Comply with all policies and attend required meetings.

Skills

Verbal and written communication

Bilingual English/Spanish

Interpersonal skills

Microsoft Office

Organizational skills

Education

High school diploma/GED

CA DHCS PACE Medi-Cal certification within 60 days

Tools

Microsoft Office

Job description

Neighborhood Healthcare seeks an Eligibility Specialist to help participants access Medi-Cal/Medicare coverage for PACE services. This onsite role involves applying for coverage, assessing options, and coordinating renewals with DHCS, County, and CMS requirements.

The position requires a high school diploma or GED, 1 year of healthcare or customer service experience, and relevant certifications. Bilingual English/Spanish preferred, with a comprehensive benefits package and growth opportunities.