Role: Medicaid Specialist, Edenbridge PACE
Location: Washington DC, 20020
Mission: To allow frail elderly people to age in the location of their choosing and continue to lead. connected, meaningful lives
Role in Brief:
The Medicaid Specialist role offers a unique opportunity to build the first PACE (Program of All-Inclusive Care for the Elderly) program in the District of Columbia within the framework of a supportive, innovative, and expert leadership team and company. Edenbridge PACE at Skyland is aiming to be the partner of choice for District seniors and their families living in Wards 7 and 8 to allow them to live dignified, meaningful lives and to remain in their own homes for as long as they desire. Together with our coalition of strong partners within the community, the Medicaid Specialist will help lead Edenbridge PACE at Skyland to have a transformative impact on a particularly under-served community.
ESSENTIAL DUTIES AND RESPONSIBILITIES
The following essential functions of this position are performed personally, in cooperation with your supervisor, and/or in coordination with other staff. Additional work functions and duties may be assigned.
- Initiates Medicaid application process for potential participants, including application completion, assisting applicants with gathering and processing verification items, application submission, coordination with case managers/social services, and tracking and follow-up of application status.
- Provides initial telephone point of contact with potential participants and participants’ families/caregivers and referral sources as needed.
- Completes home visits as necessary to aid in this process.
- Conducts consistent professional written and verbal communication with referral sources, and documents these communications in the Electronic Health Record
- Requests and tracks requests for records and other required paperwork from physician offices, and other sources as needed
- Maintains Medicaid Tracking database including tracking time to approval from submission to DMAS to approval by DMAS or the department that manages approvals.
- Prepares a variety of periodic and special reports, which may require gathering data from several sources, compiling such data, and arranging it into the proper format.
- Prepares and leads the coordination of any required interactions/forms with state or affiliated agencies to initiate or maintain participant Medicaid status.
- Supports Edenbridge PACE finance department in the validation of Medicaid payments and revenue cycle as needed and requested by finance leadership
- Associate’s degree or equivalent experience in customer service in a human services environment, business, or comparable education and experience required.
- Thorough understanding of DMAS, Medicaid, and Social Security processes
- Thorough understanding and experience working with DC Medicaid
- Extensive knowledge of community resources available to seniors and their families.
- Ability to effectively represent the program to participants, families, outside agencies, community groups, community professionals, and the public.
- Must submit to and pass a pre-employment drug/alcohol screening and criminal background check.
- Must be free of communicable diseases and fully vaccinated against Covid-19
Learn more at:
Interested candidates, please apply by submitting your resume at https://edenbridgehealth.applytojob.com/