Medi-Cal Eligibility Specialist

Habitat Health empowers older adults to experience more good days in their homes and communities. Through the Program of All-Inclusive Care for the Elderly (PACE), we provide comprehensive medical care along with support for daily needs such as meals, transportation, and in ‑ home assistance. We deliver coordinated clinical and social care in our centers and directly in participants’ homes, creating a fully integrated experience that brings peace of mind and a true sense of belonging. As we expand our scalable, affordable PACE model to meet the growing and complex needs of aging populations, our mission ‑ driven care teams continue to help participants live well on their own terms.   Habitat Health is supported by leading healthcare organizations and investors including New Enterprise Associates, Kaiser Permanente, and Town Hall Ventures. We are entering a period of significant growth and are looking for exceptional teammates to help us scale a better model of care for older adults. To learn more, visit www.habitathealth.com. Role Scope :   This is an opportunity for a highly motivated and detailed oriented individual that is responsible for supporting prospective participants and existing participants navigate Medi-Cal eligibility and redeterminations. This individual will work closely with Habitat Health’s Outreach & Enrollment to support prospective participants apply for Medi-Cal eligibility, follow-up on application status, and answer questions that prospective participants may have. This individual will also work with Habitat Health’s Health Plan team to help existing participants navigate redeterminations. This role requires a combination of excellent customer service skills, attention to detail, deep understanding of Medi-Cal eligibility and redetermination, and proficiency in managing and processing multiple Medi-Cal eligibility and redetermination applications.     Partner with center staff, health plan, and outreach & enrollment to triage Medi-Cal status issues that affect PACE eligibility   Track Medi-Cal application pipeline to inform Growth and Health Plan operations   Gather all necessary documentation to create, submit, pursue, and appeal Medi-Cal eligibility for prospective participants and existing participants for re-eligibility / redetermination with Medi-Cal    Visit senior’s homes as needed to gather necessary documentation to submit complete applications and redeterminations    Maintain a strong working relationship with the County and Local social service agencies (e.g., DPSS) to ensure seamless enrollment and re-eligibility workflow, adhere to deadlines and ensure compliance with DHCS and CMS guidelines and policies    Create and conduct Medi-Cal eligibility events at Habitat Health Centers, with community partners, and virtual sessions.      Qualifications:    Minimum of three (3) years of experience working directly with the county DPSS submitting, managing, and appealing Medi-Cal eligibility and redeterminations    Demonstrate in-depth knowledge of Medi-Cal rules, processes, practices, and options for Medi-Cal eligibility and redetermination    Demonstrated knowledge and experience with complex Medi-Cal eligibility and redetermination case management    Excellent verbal and written communication skills    Willing to work weekends as necessary, particularly for community events     Proof of medical clearance for communicable diseases, including a TB test    Proof of all immunizations is up to date    Proof of valid CA driver’s license, personal transportation, good driving record and auto insurance as required by State law   Nice to have:   Bilingual (Spanish/English) strongly preferred    A minimum of one year experience working with the frail or elderly    Experience working with the Medicare and Medicaid populations and within a healthcare organization   Compensation:    We take into account an individual’s qualifications, skillset, and experience in determining final salary. This role is eligible for medical/dental/vision insurance, paid parental leave (birthing and non-birthing parents), short and long-term disability, life insurance, flexible spending accounts, 401(k) savings, paid time off, and company-paid holidays. The expected salary range for this position is $68,600 - $78,600.  The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location.   At-Will Employment    Employment with Habitat Health is at-will. This means that either the employee or the employer may terminate the employment relationship at any time, with or without cause, and with or without notice, subject to applicable law. Nothing in this job posting or any other company document is intended to create a contract of employment, express or implied, or to alter the at-will nature of employment.   Any written or oral statements to the contrary are not authorized unless made in writing and signed by an authorized representative of the Company.   Vaccination Policy, including COVID-19 To help maintain a safe environment for our participants and team members, Habitat Health maintains vaccination and infection control policies applicable to certain roles and work locations. For COVID-19 and influenza, team members who are working in a participant care setting are required to provide either proof of vaccination or a signed declination form and comply with applicable masking requirements while in a care setting to the extent permitted by law in the applicable jurisdiction.   Habitat Health will consider requests for reasonable accommodation based on an applicant's disability, medical condition, or sincerely held religious belief, practice, or observance in accordance with applicable law.   As a condition of employment, team members are expected to comply wit