Medicaid Eligibility Manager

One Senior Care

. Manage the transition of Medicaid applications from intake teams to establish eligibility for newly enrolled Participants .

Posted 11/4/2026full-timeRemote • Pennsylvania • United StatesJunior💰 $0 - $65,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in Medicaid and Medicare eligibility regulations, with a strong focus on accuracy and detail in managing participant applications and renewals. Capable of building professional relationships with county offices and internal teams to ensure compliance and timely issue resolution.

Highest-signal resume keywords

Medicaid Eligibility RegulationsCase Management SystemsDetail-OrientedIndependent WorkCustomer Service Orientation

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medicaid Application ManagementEligibility MonitoringRenewal TrackingDocumentation CoordinationRedetermination Processes

Soft Skills

OrganizedDependablePatientConscientiousProfessional Communication

Tools & Technologies

Electronic Records Systems

Industry Keywords

Frail Population ExperienceElderly Population ExperienceHealth and Safety ScreeningsBackground ChecksPACE Programs

About the role

Key responsibilities & impact

Manage the transition of Medicaid applications from intake teams to establish eligibility for newly enrolled Participants
Monitor eligibility for pending and presumptive enrollees and respond to county requests for information
Track and manage Medicaid renewals and revalidations using established workflows and timelines
Support the appeals process on behalf of Participants when needed
Coordinate with county offices and internal teams to ensure required documentation is received and submitted accurately
Respond timely to changes in participant Medicaid Status
Conduct ongoing monitoring of eligibility, including annual and situational redeterminations
Communicate with internal teams regarding eligibility status, renewal deadlines, documentation needs, and policy changes affecting access to services
Build and maintain professional relationships with county offices to support timely issue resolution
Work primarily independently at a steady, predictable pace while supporting internal teams and external partners

Requirements

What you’ll need

High school diploma or equivalent required
Bachelor’s degree preferred
Knowledge of Medicaid, Medicare, and PACE eligibility regulations preferred
At least one year of experience working with the frail or elderly population, or willingness to complete extensive training
Experience using electronic records or case management systems is a plus
Highly detail-oriented with a strong focus on accuracy and consistency
Comfortable following clearly defined processes and procedures
Patient, conscientious, and able to double-check work to ensure quality results
Organized and dependable, with the ability to manage repetitive tasks effectively
Professional, polite, and service-oriented in all interactions
Able to work independently while collaborating as needed with internal partners
Ability to move intermittently throughout the workday
Ability to sit, stand, bend, and lift as needed
Must be able to drive a motor vehicle
Ability to travel locally and regionally, with occasional overnight travel
Successful completion of required background checks, health and safety screenings, and any clearances required for healthcare programs

Benefits

Comp & perks

9 Paid Holidays
PTO starting at 3 weeks + 1 day per year (accrued from date of hire for full-time employees)
Medical, Dental, & Vision
Free Life and AD&D Insurance Plan
Health Savings and Flexible Spending Accounts
Short Term Disability Insurance
Group Voluntary Term Life Insurance for Employee, Spouses, and Dependents
Paid Parental Leave
Tuition Reimbursement and Paid Training Opportunities
Retirement Plan with company annual match
Mileage Reimbursement at annual IRS rate as applicable
Training, mentorship, and career development programs