Medi-Cal Specialist

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.

• 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.

• 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).

• 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.
• Regional Support: This role will support both our Greater Los Angeles and South Los Angeles center.

• 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…