Senior Care Navigator for PACE & Benefits

AltaMed Health Services Corp; California; On-site; USD 35,000 - 44,000; Full time

Benefits offered by this job

Medical, Dental and Vision insurance

403(b) retirement plan

Employer matching contributions

Flexible Spending Accounts

Commuter Flexible Spending

Career Advancement & Development

Paid Time Off & Holidays

Paid CME Days

Malpractice insurance and tail

Tuition Reimbursement

Corporate Employee Discounts

Employee Referral Bonus

Pet Care Insurance

Job summary

AltaMed Health Services Corp. seeks a Participant Services Specialist to support the PACE IDT by coordinating essential services and ensuring high-quality participant experiences.

The role emphasizes assisting with inquiries, eligibility issues (Medi-Cal/Medicare), complaints, and appeals, while supporting incident documentation and disenrollments. Strong customer service skills, knowledge of Medi-Cal/Medicare, and bilingual abilities (Spanish/English or Chinese/English) are highly valued.

Qualifications

• High School diploma or equivalent with a minimum of 2 years’ customer service experience required.
• Bachelor’s degree preferred.
• Knowledge of Medi-Cal, Medicare, and Social Security benefits is required.
• PACE program knowledge is preferred.
• Experience in PACE operations, managed care operations, or other healthcare settings serving the frail or elderly is preferred.
• Bilingual Spanish/English, Chinese/English, or another second language is strongly preferred.
• A minimum requirement of a valid BLS certification or higher, following the American Heart Association (AHA) or the American Red Cross guidelines.

Responsibilities

• Assist the PACE IDT in coordinating essential PACE services and promote participant satisfaction and retention through high-quality customer service.
• Handle inquiries, service requests, eligibility issues, complaints, and appeals, and document/process incident reports and involuntary disenrollments.
• Facilitate on-site satisfaction surveys and center-wide participant experience activities; assist with linkage and referrals to community resources.
• Work with interdisciplinary teams to achieve program goals while adhering to state and federal regulations.

Skills

Bilingual Spanish/English

Customer service

Bilingual Chinese/English

Education

High School diploma or equivalent

Bachelor’s degree preferred

Job description

AltaMed Health Services Corp. seeks a Participant Services Specialist to support the PACE IDT by coordinating essential services and ensuring high-quality participant experiences.

The role emphasizes assisting with inquiries, eligibility issues (Medi-Cal/Medicare), complaints, and appeals, while supporting incident documentation and disenrollments. Strong customer service skills, knowledge of Medi-Cal/Medicare, and bilingual abilities (Spanish/English or Chinese/English) are highly valued.