Medi-Cal Specialist
8 days ago
East Rancho Dominguez
Job DescriptionAbout This RoleIf you’re passionate about serving underserved communities in Los Angeles County, this role is a chance to make a direct, lasting impact. As the Medi-Cal Specialist, you’ll help bring PACE (Program of All-Inclusive Care for the Elderly) to frail seniors—guiding them through new and renewal Medi-Cal/Medicare processes so they can remain safely at home, for as long as they wish. You’ll be the go-to expert who turns a complex system into a clear path: completing applications (often through home visits), keeping documentation spotless in our CRM, coordinating with county/state partners, and collaborating closely with Finance, Enrollment, and Outreach. The ideal candidate brings hands-on knowledge of Medi-Cal/Medicare eligibility and recertification, a resourceful approach to connecting families with community support, and a heart for working with older adults.What Does Success Look Like In This Role? • Own the application journey: Initiates, assists, and manages Medi-Cal applications for prospective participants, ensuring timely and accurate completion., • Meet people where they are: Conducts home visits to complete the Medi-Cal application process., • Make every record count: Maintains all documentation and records all enrollment activities in CRM software; ensures accuracy and compliance., • Lead with integrity: Strictly adheres to DHCS and CMS regulations and policies regarding PACE marketing practices., • Turn data into clarity: Collaborates with the Finance department to prepare reports for data analysis., • Keep coverage on track: Monitors and maintains participants’ Medicaid eligibility, including Medi-Cal recertifications., • Double-check the dollars: Supports the Finance department in validating Medicaid payments., • Be the extra set of hands: Supports Enrollment and Outreach Specialists as needed., • Connect families to help: Provides community resources to prospective participants and families/caregivers., • Guide the paperwork process: Assists participants and families/caregivers with all paperwork needed for Medicaid re-determination or new applications., • Coordinate with the county/state: Collaborates with or contacts county/state government specialists to ensure submission of required documentation and to obtain additional information., • Jump in where needed: Performs other duties as assigned.What Does An Ideal Candidate Look Like?, • Know the system: Knowledge of the California Medi-Cal system and the Social Security process., • Bring real experience: 2–4 years of relevant experience., • Navigate government partners: Experience working with state/county eligibility workers., • Be a resource guru: Extensive knowledge of community resources., • Champion older adults: Experience working with frail elderly populations., • Education matters: High school diploma., • Ready to drive: Valid CA driver’s license, personal transportation, good driving record, and auto insurance as required by state law., • Speak their language: Bilingual skills preferred (Spanish, Cantonese, Mandarin, or Vietnamese).The Fine Print, • Set your rhythm: Monday–Friday, 8:00 a.m.–5:00 p.m., with flexibility for occasional weekend support., • Work where it matters: Hybrid schedule—split your time between the office and the community., • Bring the care to them: Regular local travel to meet participants where they are.The Physical Requirements and Work Environments, • Where you’ll work: Hybrid across home/remote, clinic, and community settings. Expect a mix of desk time, in-person meetings, home visits, and occasional office-based collaboration., • On the move: Frequent local travel to participant homes, community sites, and county/partner offices; driving your personal vehicle as needed., • Time on task: Long periods of sitting for documentation and calls, with intermittent standing, walking, and stair navigation in varied home and facility environments., • People-forward: Frequent speaking and active listening with participants, families, caregivers, and county/state partners—both in person and via phone/video., • Tools of the trade: Independent use of computers, smartphones, CRM/EMR systems, and virtual meeting platforms; accurate typing/data entry and document management., • Hands-on basics: Ability to lift/carry up to 25 lbs. occasionally (e.g., a laptop bag, forms, portable printer/scan kit) and to set up basic field equipment., • Environment changes: Exposure to typical clinic conditions and variable home settings (temperature, pets, stairs, noise); occasional outdoor walking between locations., • Safety & professionalism: Adheres to site safety protocols; uses PPE as required; practices situational awareness in community settings., • Visual & auditory needs: Sufficient vision/hearing to review documents, verify IDs, read forms, and conduct phone/video conversations clearly.