Eligibility Specialist

JOB SUMMARY

The Eligibility Specialist for the PACE Program is responsible for guiding prospective participants through the eligibility and enrollment process, ensuring they understand the benefits of the program and qualify for services. The role also includes building relationships with the community by attending and scheduling events to promote the program and establishing a referral pipeline. As a hybrid position, the Intake Specialist will work across enrollment, intake, and marketing to help the PACE program reach its growth goals, but will primarily focus on the intake processes, including the Medicaid application process.

KEY RESPONSIBILITIES

Enrollment and Intake Process:

Serve as the primary point of contact for prospective PACE participants, ensuring they are informed about the program's services and benefits. Guide participants and their families through the eligibility and enrollment process, including explaining the criteria, assisting with Medicaid application paperwork, and verifying documentation. Conduct assessments to determine eligibility and work closely with the interdisciplinary team to ensure proper care coordination during the intake process.

Community Outreach and Marketing:

Attend, schedule, and coordinate community outreach events to increase awareness of the PACE program and generate participant referrals. Build and maintain relationships with community organizations, healthcare providers, senior centers, and other relevant agencies to develop a consistent referral pipeline. Represent the PACE program at health fairs, senior expos, and other local events to inform the public about available services. Assist with developing marketing materials and presentations to promote the PACE program in the community.

Referral and Relationship Management:

Develop and manage a network of referral sources, following up regularly to ensure a continuous flow of qualified leads. Work with internal teams to improve the efficiency of the enrollment and intake process and ensure a seamless transition for new participants into the PACE program.

Documentation and Reporting:

Maintain accurate and up-to-date records of all prospective participants, including referral sources, intake information, and progress throughout the enrollment process. Report on enrollment activities, including participant pipeline status, marketing efforts, and community outreach successes. Ensure compliance with state and federal regulations regarding participant eligibility and program enrollment. Other duties as assigned.

EDUCATION & EXPERIENCE REQUIRED

At least 2 years of experience in enrollment, intake, marketing, or community outreach, preferably in healthcare or with a senior population. Experience with PACE programs, long-term care, or healthcare services Experience with state Medicaid enrollment processes required. Must complete ACHA Background check/fingerprinting .

Job Type:

Full-time Benefits:

401(k) Dental insurance Health insurance Paid time off Tuition reimbursement Vision insurance

Experience:

enrollment, marketing, community outreach in healthcare: 2 years (Required) Medicaid enrollment process : 1 year (Required)

PACE Program, LTACH:

1 year (Required) Ability to

Commute:

Davie, FL 33317 (Preferred) Willingness to travel: 25% (Required)

Work Location:

In person