Eligibility Specialist I

Eligibility Specialist I

The Program of All-Inclusive Care for the Elderly (PACE) offers a variety of services, with many of them provided onsite at a PACE Center. PACE is an alternative to nursing home care and through an interdisciplinary care team (IDT) of physicians, nurse practitioners, nurses, social workers, therapists, van drivers, and aides coordinates and provides preventive, primary, acute, and long-term care services, so older individuals can continue living in the community.

Why You'll Love it Here:

PurposeProfessional DevelopmentPaid HolidaysPTO and Sick TimeInternal opportunities for growthTeam Support - Competitive PayMedical, Dental, Vision InsuranceLife insurance403(b) Retirement SavingsEmployee AssistanceAnd MORE!

Help connect seniors with the care and benefits they deserve.

Are you detail-oriented, organized, and passionate about helping others? As an Eligibility Specialist I, you'll play a key role in ensuring older adults receive the Medicaid benefits they need to access high-quality care through our PACE program. Working alongside our interdisciplinary team, you'll guide participants and their families through the eligibility process while ensuring compliance with federal, state, and organizational requirements.

What You'll Do

• Process Medicaid and Food Assistance applications and eligibility paperwork.
• Verify participant eligibility and monitor applications to ensure timely processing.
• Assist participants and families with Medicaid enrollment and redetermination processes.
• Communicate with participants, caregivers, referral sources, physician offices, and community partners regarding eligibility requirements.
• Maintain accurate documentation and participant records in accordance with CMS and organizational standards.
• Coordinate with the Enrollment Coordinator, Eligibility Specialist II, Social Workers, and DHHS to support accurate eligibility determinations.
• Manage ongoing Medicaid status updates, transitions of care paperwork, and special eligibility situations.
• Track deadlines and ensure all required documentation is completed accurately and on time.
• Support a participant- and family-centered approach by collaborating with everyone involved in the participant's care.

What We're Looking For

• High school diploma or equivalent.
• At least one year of experience with DHS/Medicaid applications (long-term care Medicaid experience preferred).
• One year of experience working with frail older adults or in a long-term care setting.
• Strong organizational, problem-solving, and time management skills.
• Excellent written and verbal communication skills.
• Ability to maintain confidentiality and handle sensitive information with professionalism.
• Proficiency with Microsoft Office, including Word, Excel, Outlook, PowerPoint, and SharePoint.
• Ability to interpret Medicaid eligibility requirements and work independently while collaborating effectively with a team.

Additional Requirements

• Must be fully vaccinated or willing to become vaccinated against:
• Influenza, MMR, Varicella, Tdap/Td, COVID-19, and Hepatitis B
• Must meet CMS competency standards prior to working independently
• Must be willing to work beyond normal hours

Join Us! If you're ready to do meaningful work in a place where you feel you truly belong, where partnership drives every interaction, and where excellence and ownership guide how we care for our participants and one another, we invite you to apply. Senior Care Partners PACE is proud to be an Equal Employment Opportunity employer.