About This Role
If you’re passionate about serving underserved communities in Los Angeles County, this role is a chance to make a direct, lasting impact. As the Medi-Cal Specialist, you’ll help bring PACE (Program of All-Inclusive Care for the Elderly) to frail seniors—guiding them through new and renewal Medi-Cal/Medicare processes so they can remain safely at home, for as long as they wish.
You’ll be the go-to expert who turns a complex system into a clear path: completing applications (often through home visits), keeping documentation spotless in our CRM, coordinating with county/state partners, and collaborating closely with Finance, Enrollment, and Outreach. The ideal candidate brings hands-on knowledge of Medi-Cal/Medicare eligibility and recertification, a resourceful approach to connecting families with community support, and a heart for working with older adults.
What Does Success Look Like In This Role?
Own the application journey: Initiates, assists, and manages Medi-Cal applications for prospective participants, ensuring timely and accurate completion.
Meet people where they are: Conducts home visits to complete the Medi-Cal application process.
Make every record count: Maintains all documentation and records all enrollment activities in CRM software; ensures accuracy and compliance.
Lead with integrity: Strictly adheres to DHCS and CMS regulations and policies regarding PACE marketing practices.
Turn data into clarity: Collaborates with the Finance department to prepare reports for data analysis.
Keep coverage on track: Monitors and maintains participants’ Medicaid eligibility, including Medi-Cal recertifications.
Double-check the dollars: Supports the Finance department in validating Medicaid payments.
Be the extra set of hands: Supports Enrollment and Outreach Specialists as needed.
Connect families to help: Provides community resources to prospective participants and families/caregivers.
Guide the paperwork process: Assists participants and families/caregivers with all paperwork needed for Medicaid re-determination or new applications.
Coordinate with the county/state: Collaborates with or contacts county/state government specialists to ensure submission of required documentation and to obtain additional information.
Jump in where needed: Performs other duties as assigned.
What Does An Ideal Candidate Look Like?
Know the system: Knowledge of the California Medi-Cal system and the Social Security process.
Bring real experience: 2–4 years of relevant experience.
Navigate government partners: Experience working with state/county eligibility workers.
Be a resource guru: Extensive knowledge of community resources.
Champion older adults: Experience working with frail elderly populations.
Education matters: High school diploma.
Ready to drive: Valid CA driver’s license, personal transportation, good driving record, and auto insurance as required by state law.
Speak their language: Bilingual skills preferred (Spanish, Cantonese, Mandarin, or Vietnamese).
The Fine Print
Set your rhythm: Monday–Friday, 8:00 a.m.–5:00 p.m., with flexibility for occasional weekend support.
Work where it matters: Hybrid schedule—split your time between the office and the community.
Bring the care to them: Regular local travel to meet participants where they are.
The Physical Requirements and Work Environments
Where you’ll work: Hybrid across home/remote, clinic, and community settings. Expect a mix of desk time, in-person meetings, home visits, and occasional office-based collaboration.
On the move: Frequent local travel to participant homes, community sites, and county/partner offices; driving your personal vehicle as needed.
Time on task: Long periods of sitting for documentation and calls, with intermittent standing, walking, and stair navigation in varied home and facility environments.
People-forward: Frequent speaking and active listening with participants, families, caregivers, and county/state partners—both in person and via phone/video.
Tools of the trade: Independent use of computers, smartphones, CRM/EMR systems, and virtual meeting platforms; accurate typing/data entry and document management.
Hands-on basics: Ability to lift/carry up to 25 lbs. occasionally (e.g., a laptop bag, forms, portable printer/scan kit) and to set up basic field equipment.
Environment changes: Exposure to typical clinic conditions and variable home settings (temperature, pets, stairs, noise); occasional outdoor walking between locations.
Safety & professionalism: Adheres to site safety protocols; uses PPE as required; practices situational awareness in community settings.
Visual & auditory needs: Sufficient vision/hearing to review documents, verify IDs, read forms, and conduct phone/video conversations clearly.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Unlock Care, One Application at a Time
If you’re energized by helping underserved seniors access the care they deserve—and you know your way around Medi-Cal/Medicare—this is your moment. Join us to turn a complex process into a clear path home for our participants. Ready to make an impact? Apply today and let’s do this together.
