PACE Eligibility Navigator: Health Coverage Enroller

San Ysidro Health; San Diego, Northern (CA, KY); Hybrid; USD 60,000 - 80,000; Full time

Job summary

San Ysidro Health is seeking a PACE Eligibility Navigator to support enrollment and retention for San Diego PACE participants. You will verify Medi-Cal and Medicare eligibility accurately and timely, collaborating with internal teams, participants and state agencies.

Responsibilities include completing renewal packages, facilitating enrollments, and maintaining data integrity across SD PACE systems. The role requires knowledge of public health guidelines and strong communication skills in a

Qualifications

• 2+ years of Medi-Cal/Medicare eligibility coordination experience.

Responsibilities

• Initiates and monitors health coverage renewal processes.
• Assists individuals in applying for/retaining health coverage.
• Complete and submit health coverage applications and follow up with agencies.
• Review Medicare eligibility monthly and identify issues.
• Process enrollment/re-enrollment through CMS portal.

Skills

Medi-Cal eligibility

Medicare eligibility

DHCS guidelines

CMS guidelines

Bilingual English/Spanish

Education

High School Diploma or GED

Bachelor’s degree in health/human services

CA driver’s license with insurance

Tools

EPIC

Quick Cap

Apptivo

DHCS Provider Portal

Benefits Cal

CMS

Availity

Job description

San Ysidro Health is seeking a PACE Eligibility Navigator to support enrollment and retention for San Diego PACE participants. You will verify Medi-Cal and Medicare eligibility accurately and timely, collaborating with internal teams, participants and state agencies.

Responsibilities include completing renewal packages, facilitating enrollments, and maintaining data integrity across SD PACE systems. The role requires knowledge of public health guidelines and strong communication skills in a