Medicaid Waiver Specialist

Job Description

Job Description

Job Summary :

The ADRC serves elders aged 65 or older, adults aged 18-64 with a disability, and their caregivers. Staff support informed decision making, provide Medicaid eligibility assistance for the Statewide Medicaid Managed Care Long-term Care Program (SMMCLTCP), and provide the following duties and responsibilities through customer service that is streamlined, efficient, and consumer-friendly.

Duties and Responsibilities :

Medicaid Outreach and LTCPE, including :

• Counsel individuals on the Statewide Medicaid Managed Care Long-term Care Program (SMMCLTCP), available services, eligibility requirements, the application process, and additional information sources.
• Provide outreach that is standardized and consistent statewide to ensure public awareness of Medicaid programs and services and how to access them.
• Build relationships with and educate service providers and other professionals to facilitate referrals and increase awareness of Medicaid resources.

Medicaid Eligibility Screening and Pre-enrollment (APCL / Waitlist) Placement , including :

Accept referrals from the ADRC Helpline and other sources for screening utilizing the DOEA approved 701S screening instrument.

Determine the individual’s needs and enroll on the pre-enrollment list (APCL / waitlist).

Ensure accurate data entry into eCIRTS, and SharePoint.

Inform individuals or individual’s representatives about potential eligibility for the Medicaid programs, including their rights and responsibilities.

Re-evaluate individuals on the pre-enrollment list (APCL / waitlist) using the standardized screening instrument as required or as requested due to a significant change.

Enrollment Management System ( EMS), including :

Provide the duties outlined in the most recent DOEA EMS release procedure.

Contact individuals on the release verbally and in writing.

Verify an individual’s current Medicaid eligibility status.

Assist the client to pursue the eligibility process with meeting SMMCLTCP financial and medical eligibility.

Work with client to obtain the Physician Referral form (3008).

Coordinate with CARES (Comprehensive Assessment and Review for Long Term Care Services) staff for determination of medical eligibility.

Track Medicaid applications through the eligibility process.

Act as a consumer advocate by coordinating with CARES and DCF / ESS staff to resolve in a timely manner any eligibility issues that arise during the Medicaid eligibility determination process.

Assist clients who have lost Medicaid to regain their active status in SMMCLTCP.

Grievances and Complaints , including :

Provide assistance to SMMCLTCP enrollees, concerning how to file grievances and complaints with the long-term care plans.

Provide information concerning Medicaid Fair Hearings.

Maintain a record of such complaints, in accordance with statewide procedures.

Quality Assurance , including :

Assist with quality assurance reviews of 701S and long-term care education contacts by ADRC staff.

Assist with insuring eCIRTS data integrity.

Assist with tracking and reviews of EMS processing to ensure contractual compliance.

Education :

Possess a bachelor’s degree from an accredited college or university; or

Have an Associate of Arts Degree from an accredited college or university and a minimum of one year experience as a caseworker, case manager, intake specialist, or experience in performing human services related work; or

Have a high school diploma or GED and two years’ experience as a caseworker, case manager, intake specialist, or experience in performing human services related work.

Skills / Qualifications :

Knowledge of computer applications to perform the functions of the position, including word processing, database, and spreadsheet applications.

The ability to work independently and with minimal supervision.

Knowledge of available ADRC administered programs and available Medicaid programs.

The ability to work with disabled adults, elders, caregivers, stakeholders, and community partners in a knowledgeable, engaged, and compassionate manner.

The ability to set and track personal performance goals to efficiently manage workload.

Special Requirements : Must pass DOEA Level II criminal background screening; must sign Medicaid Attestation Payroll Form per Department of Elder Affairs / AAAPP requirements. Must sign SMMCLTC Program – Prohibited Activities.

Equal Opportunity Employer :

At AAAPP, we take pride in providing equal employment opportunities to everyone regardless of their race, ethnicity, beliefs, religion, marital status, gender, citizenship status, age, veteran status, or disability.

Accordingly, the purpose of this policy is to reinforce our commitment to the creation and maintenance of a diverse workplace where equality, respect, and consideration for one another are the norm.

Excellent Benefits

No phone calls.

DF / SF WP EOE

Job Type : Full-time

Salary : $21.00 per hour

Benefits :

401(k)

401(k) matching

Dental insurance

Flexible spending account

Health insurance

Life insurance

Paid time off

Vision insurance

Schedule :

Monday to Friday

Education :

High school or equivalent (Required)

Experience :

Case management : 1 year (Required)

Work Location : Hybrid remote in Saint Petersburg, FL 33702