W

WelbeHealth

PACE-based elder care provider

Medicaid Enrollment Specialist

Case Management & AdvocacyUpdated on Nov 11
Full-timeNewark, NJ, USA

About the Job

Requirements

  • A bachelor's degree in a relevant field is preferred, or five additional years of relevant Medicaid enrollment experience may be substituted.
  • At least three years of experience working directly with county Department of Public and Social Services submitting, managing, and appealing Medi-Cal enrollments is required.
  • Demonstrated knowledge and experience with complex Medicaid enrollment case management is required.

Responsibilities

  • Gather all necessary documentation to create, submit, pursue, and appeal Medicaid enrollments for prospective participants.
  • Visit seniors' homes as needed to gather documentation for complete applications.
  • Maintain a strong working relationship with the county Department of Public and Social Services to ensure a seamless enrollment workflow, adhere to deadlines, and ensure compliance with Department of Health Care Services and Centers for Medicare & Medicaid Services guidelines and policies, including marketing guidelines and denials policies.
  • Create and conduct Medicaid enrollment events weekly at each WelbeHealth center in the territory, monthly at senior housing, hospitals, senior centers, and churches, and monthly as virtual enrollment sessions.
  • Apply in-depth knowledge of Medicaid rules, processes, practices, and enrollment options, including share of cost, spousal impoverishment protections, and appeals processes.
  • Provide back-up and support to Outreach and Enrollment functions as assigned.

Desired Qualifications

  • Bilingual Spanish/English ability is strongly preferred.

About the Company

WelbeHealth

PACE-based elder care provider

WelbeHealth provides comprehensive, coordinated care for older adults using the Program of All-Inclusive Care for the Elderly (PACE). It integrates medical, social, and long-term services to help eligible seniors stay in their homes instead of nursing facilities. Care is delivered through individualized plans developed with patients and families, and includes medical care, physical therapy, social activities, and transportation. Funding comes from Medicare and Medicaid, with additional private payments for certain services. The company differentiates itself by applying the PACE model to deliver all-inclusive, home- and community-based care with a team-led, patient-centered approach designed to maintain independence and improve quality of life. Its goal is to keep seniors healthy, independent, and in their homes for as long as possible through personalized, coordinated care.

Company size
1,001-5,000
Company stage
Series C
Total funding
$61.2M
Headquarters
Menlo Park, CA
Founded
2015

Recently Posted Jobs

Explore more opportunities at WelbeHealth

See more jobs