You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a Navigator to oversee Medicare and Medicaid eligibility and entitlements. The primary responsibilities include managing participant paperwork, collaborating with internal teams, ensuring compliance with federal and state regulations, and processing enrollments and disenrollments efficiently.

Key Responsibilities

• Oversee Medicare and/or Medicaid prospects and participants’ eligibility and entitlement.
• Ensure all required paperwork is signed and uploaded into the database before enrollment.
• Collaborate with Social Workers, Finance, and staff on Medicaid and Medicare entitlement processes.
• Use software for Medicare and Medicaid issue resolution, ensuring compliance with regulations.
• Lead submission of personal financial forms for eligibility processes.
• Develop processes to meet enrollment and business goals.
• Manage participant eligibility to optimize premium payments and resolve issues.
• Ensure compliance with all state and federal laws regarding Medicaid and Medicare.
• Attend seminars and integrate new entitlement rules into activities.
• Generate reports for internal and external enrollment tracking.

Qualifications

• Bachelor’s degree in entitlement or related health field preferred.
• Strong computer skills in Word, Excel, and statistical analysis.
• Fluency in a secondary language is a plus.

Experience

• 2-3 years of experience in nursing home, Medicaid, Medicare, MLTC, MAP, D-SNP, and/or PACE long-term care products.
• Experience in Social Services or related government agencies.
• Deep knowledge of Medicare and Medicaid eligibility for dual eligible and frail adult populations.

Skills

• Excellent interpersonal and communication skills.
• Highly organized and able to meet tight deadlines.
• Ability to multi-task in a constantly changing environment.
• Preferred experience with Care Compass/E-Paces/MARX/Tableau.

Schedule/Shift

Monday - Friday 8:00am-5:00pm (1 hour lunch)

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language

Medix is an Equal Opportunity Employer.

^*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).

Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

Any required state or Joint Commission training is compensated at the state or local minimum wage rate.

^*As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.