Medicaid Eligibility Lead

Job Summary

A company is looking for an Eligibility Lead to manage complex eligibility challenges and ensure participant coverage.

Key Responsibilities

• Act as the expert in Medicare or Medicaid eligibility policies and keep teams updated on regulatory changes
• Advise executive leadership on eligibility-related risks and ensure compliance with federal and state regulations
• Oversee resolution of complex eligibility issues and advocate for participants in disputed cases

Required Qualifications

• Associate's or bachelor's degree in a relevant field preferred; relevant professional experience may be substituted
• Minimum of five (5) years of experience in Medicaid, Medicare eligibility, or social services
• Minimum of three (3) years of experience working with governmental agencies, with direct experience with CMS highly desired
• Experience leading in a data-driven organization, utilizing reports and data for project management