Medicaid Enrollment & Eligibility Specialist•HCBS Programs Hybrid | Harrisburg, PA | $26•27/hour Apply and contact for more info: Katherine 586-710-0022

Location:

Hybrid•Harrisburg, PA / Work from

Home Pay Rate:

$26.00•27.00 per hour Position Summary Join the Office of Long-Term Living (OLTL) Enrollment Unit and play a vital role in supporting Pennsylvania's Home and Community-Based Services (HCBS) programs. This position is responsible for overseeing enrollment and eligibility processes, monitoring vendor contract compliance, analyzing program data, and providing technical guidance to stakeholders to ensure individuals receive timely access to long-term services and supports. This is a hybrid position based in Harrisburg, PA , offering a combination of in-office and work-from-home flexibility. Key Responsibilities Review and analyze operational reports submitted by the Independent Enrollment Broker (IEB) and Community HealthChoices (CHC) Managed Care Organizations (MCOs) to monitor contract compliance and performance. Conduct performance reviews, identify compliance issues, and recommend corrective actions to improve vendor performance. Assist with the development, implementation, and maintenance of tracking systems and reporting tools used to monitor contract compliance. Respond to enrollment and eligibility inquiries from the Office of Legislative Affairs and other Commonwealth offices through written and verbal communication. Provide technical guidance to the Independent Enrollment Broker (IEB), Service Coordinators, Managed Care Organizations, providers, and other stakeholders regarding eligibility and enrollment policies, procedures, and regulations. Review daily, monthly, and quarterly reports to identify enrollment issues, eligibility discrepancies, and system errors impacting participant enrollment. Research and resolve enrollment issues by collaborating with state agencies, Managed Care Organizations, Service Coordination agencies, the Office of Income Maintenance, the LIFE Program, and other stakeholders. Participate in hearings related to eligibility determinations and enrollment appeals as needed. Prepare weekly activity reports and maintain accurate program documentation. Utilize systems including Client Information System (CIS), PROMISe, Home and Community Services Information System (HCSIS), and SAMS/WellSky to ensure enrollment activities comply with established regulations. Interpret policies and regulations while providing technical assistance to providers and stakeholders. Participate on workgroups focused on policy development, operational improvements, regulations, work plans, system enhancements, and enrollment procedures. Attend team, Division, and Bureau meetings. Perform other related duties as assigned. Required Qualifications Bachelor's degree in Social Work, Human Services, Healthcare Administration, Public Health, or a related field preferred. Minimum of two years of experience working with Medicaid Home and Community-Based Services (HCBS), long-term care services, or related human services programs. Experience using Microsoft Office, with strong proficiency in Microsoft Excel. Excellent written and verbal communication skills. Strong analytical, organizational, and problem-solving abilities. Ability to interpret policies, regulations, and program requirements. Experience working collaboratively with vendors, agencies, providers, and professional stakeholders. Ability to work independently while managing multiple priorities. Strong attention to detail and organizational skills. Ability to quickly learn Commonwealth policies, procedures, and business practices. Public speaking or presentation experience is a plus. Preferred Qualifications Experience with Pennsylvania Office of Long-Term Living (OLTL) programs. Knowledge of Medicaid eligibility and enrollment processes. Familiarity with Community HealthChoices (CHC), HCBS Waiver Programs, Act 150, and LIFE Programs. Experience with HCSIS, Client Information System (CIS), PROMISe, and SAMS/WellSky. Experience monitoring vendor contracts or regulatory compliance. Knowledge of CMS regulations and Medicaid program requirements. Human Services, Social Work, Case Management, Care Coordination, Service Coordination, Supports Coordination, Medicaid, Home and Community-Based Services (HCBS), Long-Term Services and Supports (LTSS), Medicaid Eligibility, Enrollment, Community HealthChoices (CHC), Independent Enrollment Broker (IEB), Long-Term Care, Managed Care Organizations (MCOs), Contract Compliance, Vendor Management, Quality Assurance, Regulatory Compliance, CMS, Healthcare Administration, Public Health, Policy Interpretation, Technical Assistance, Program Specialist, Human Services Specialist, Medicaid Program Specialist, Enrollment Specialist, Eligibility Specialist, HCBS Program Specialist, Case Manager, Care Manager, Care Coordinator, Service Coordinator, HCSIS, Client Information System (CIS), PROMISe, SAMS, WellSky, Microsoft Excel, Data Analysis, Reporting. Skills Contract compliance and vendor oversight Enrollment and eligibility review Microsoft Excel and Microsoft Office Suite Data analysis and reporting Regulatory compliance Policy interpretation Technical assistance and stakeholder support Written and verbal communication Critical thinking and problem-solving Time management and organization Collaboration and relationship management Compensation & Benefits Competitive pay: $26.00•27.00 per hour Comprehensive benefits package , including: Medical, Dental, and Vision insurance 401(k) with company match Paid Time Off (PTO) 12 Paid Holidays Hybrid work schedule with a combination of in-office work in Harrisburg, PA and work-from-home flexibility Opportunity to support Pennsylvania's Medicaid enrollment programs and help ensure eligible participants receive access to critical long-term care services. ESJKS2

Pay:

$26.00•$27.00 per hour

Benefits:

401(k) 401(k) matching Dental insurance Health insurance Health savings account Life insurance Paid time off Vision insurance

Work Location:

Hybrid remote in Harrisburg, PA 17111