Medicaid Support Specialist

The Medicaid Support Specialist (MSS) supports consumers and family caregivers in navigating Medicaid and Waiver enrollment as well as provides on-going eligibility support to ensure the continuity of services at Careforth. This individual will use their experience and expertise with state Medicaid programs and waiver programs to provide guidance both internally and externally to help qualified individuals gain access to Careforth programs and services. #LI-REMOTE

• Develop strong relationships and good rapport with state Medicaid agency professionals, Access Agencies, and case managers responsible for Medicaid and Waiver applications; Help Careforth become a preferred partner to work with
• Review Medicaid and Waiver applications to ensure consumers are eligible for Careforth programs and caregivers meet state and Careforth requirements; Provide alternative resources for ineligible families as needed
• Work collaboratively with Careforth’s enrollment teams, external case managers, and caregivers to assist families in obtaining the appropriate coverage to participate in Careforth programs
• Stay abreast of state/federal regulations and trends related to Medicaid programs and waivers that support caregiver coaching and Structured Family Caregiving (SFC); perform initial research into new programs for state and federal requirements for eligibility information as needed
• Capture and document key processes associated with successful Medicaid and waiver approval to develop and support workflow and staff education, as well as provide oversight of applications through approval; Review and update case notes within case management system as needed using established system protocols.
• Provide consumers with on-going determination and eligibility support; resolve loss of coverage events
• Provide insights, data and reporting to support initiatives in key Careforth departments in collaboration with Growth leadership
• Perform other duties as assigned

• Bachelor’s degree in health care or related discipline or equivalent work experience
• 4-6 years of experience in health care and 2+ years of direct experience with Medicaid and other federal and/or state government programs
• Proven success developing professional and collaborative relationships with diverse groups
• Tech savvy with ability to toggle between multiple systems and programs; Strong MS Office skills required
• Outstanding customer service; strong oral and written communication skills
• Bi-lingual skills preferred

Careforth is an Equal Opportunity Employer*

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  Careforth supports families with diverse backgrounds and as an equal opportunity employer, we seek employees who reflect the diverse population we serve. Careforth complies with all applicable laws concerning hiring and employment practices and is firmly committed to fostering and maintaining a workplace free from discrimination. We pledge to hire, train, and promote our employees without regard to race, religion, gender, gender identity, genetic information, age, national origin, sexual orientation, disability, veteran status, or any other category protected by applicable law.