Medicaid Eligibility Manager

This is a fully remote position, open to applicants in Pennsylvania.

📋 Description

• Oversee the transition of Medicaid applications from intake teams to determine eligibility for newly enrolled Participants.

• Monitor eligibility for pending and presumptive enrollees while addressing county information requests.

• Track and manage Medicaid renewals and revalidations by following established workflows and timelines.

• Provide support during the appeals process on behalf of Participants as necessary.

• Collaborate with county offices and internal teams to ensure the accurate receipt and submission of required documentation.

• Respond promptly to changes in participant Medicaid status.

• Conduct ongoing eligibility monitoring, including annual and situational redeterminations.

• Communicate with internal teams about eligibility status, renewal deadlines, documentation requirements, and policy changes impacting access to services.

• Develop and maintain professional relationships with county offices to facilitate timely issue resolution.

• Primarily work independently at a consistent pace while providing support to internal teams and external partners.

⛳️ Requirements

• High school diploma or equivalent is mandatory.

• A Bachelor’s degree is preferred.

• Familiarity with Medicaid, Medicare, and PACE eligibility regulations is preferred.

• A minimum of one year of experience working with the frail or elderly population, or a willingness to undergo extensive training.

• Experience with electronic records or case management systems is an advantage.

• Highly detail-oriented with a strong emphasis on accuracy and consistency.

• Comfortable adhering to clearly defined processes and guidelines.

• Patient, diligent, and capable of double-checking work to guarantee quality results.

• Organized and reliable, with the ability to effectively manage repetitive tasks.

• Professional, courteous, and service-oriented in all interactions.

• Capable of working independently while collaborating with internal partners as needed.

• Ability to move intermittently throughout the workday.

• Ability to sit, stand, bend, and lift as required.

• Must possess a valid driver's license.

• Willingness to travel locally and regionally, with occasional overnight travel.

• Successful completion of necessary background checks, health and safety screenings, and any required clearances for healthcare programs.

🏝️ Benefits

• 9 Paid Holidays

• PTO starting at 3 weeks + 1 day per year (accrued from date of hire for full-time employees)

• Medical, Dental, & Vision coverage

• Free Life and AD&D Insurance Plan

• Health Savings and Flexible Spending Accounts

• Short Term Disability Insurance

• Group Voluntary Term Life Insurance for Employees, Spouses, and Dependents

• Paid Parental Leave

• Tuition Reimbursement and Paid Training Opportunities

• Retirement Plan with company annual match

• Mileage Reimbursement at the annual IRS rate as applicable

• Training, mentorship, and career development programs