Medicaid Eligibility Coordinator

Overview: Provides support to prospective members, members and their families including community resource planning, advocacy, skill building, linking patient/families to community resources and providing assistance with entitlements. Participates in clinical team meetings; works collaboratively with other VNS Health Plans staff to ensure that prospective members/ members have appropriate Medicaid eligibility and receive appropriate MLTC services.

Overview: Provides support to prospective members, members and their families including community resource planning, advocacy, skill building, linking patient/families to community resources and providing assistance with entitlements. Works closely with client, support system and/or family to obtain Medicaid and connect client to appropriate MLTC in the community. Works under close supervision. Responsibilities:

What We Provide

• Referral bonus opportunities   
• Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays 
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability  
• Employer-matched 401k retirement saving program
• Personal and financial wellness programs  
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care and commuter transit program    
• Generous tuition reimbursement for qualifying degrees 
• Opportunities for professional growth and career advancement and CEU credits  

What You Will Do

• Performs outreach to community agencies in order to establish working relationships and provides access to other services.  Advises other agencies of the program and referral process.
• Works closely with client, support system and/or family to obtain Medicaid and connects client to appropriate MLTC in the community. Conducts face-to-face encounters with members to aid assessment process, as needed.
• Screens financial records of clients/families to assist in assessment of enrollment eligibility.
• Contacts the appropriate program staff to recommend third party reimbursement, entitlements and community resources for clients/families to ensure that they have access to the adequate entitlement benefits.
• Maintains records and statistics in accordance with program requirements.  Documents services planned and provided; maintains written and verbal communication records according to VNS Health policies.
• Participates in clinical team meetings; works collaboratively with other VNS Health Plans staff to ensure that prospective members/ members have appropriate Medicaid eligibility and receive appropriate MLTC services.
• Arranges transportation and/or appointments for members to relevant offices/ sites, as needed.
• Attends in-service education programs and other training as required by VNS Health and funding sources.
• Assumes responsibility for continued professional growth. 
• Participates in special projects and performs other duties as assigned.

Qualifications:

Licenses and Certifications:

• Valid driver’s license may be required, as determined by operational needs.

Education:

• Associate's Degree in a relevant field, or the equivalent combination of education and work experience Required

Work Experience:

• Minimum of two years’ work experience in a health care or human services setting Required

• Knowledge of Medicaid eligibility and Medicaid Managed Care regulations Preferred

• Bilingual skills may be required, as determined by operational needs.

• Position may require travel between regions.
   

Pay Range: USD $23.17 - USD $28.96 /Hr.