Hybrid Remote Medicaid Eligibility Specialist – Pennsylvania (Work‑From‑Home & On‑Site) – Entry‑Level Healthcare Benefits Coordination Role

Who We Are – Transforming Home‑Based Care Across America

Founded in 2016, Freedom Care is a trailblazing healthcare organization that is redefining how home‑care services reach families in need. As the largest consumer‑directed home‑care agency in New York State, we have expanded our footprint to multiple states, including Pennsylvania, by pairing compassionate, highly‑trained caregivers with patients who deserve dignity, respect, and independence while receiving care at home. Our innovative blend of technology, patient‑centered philosophy, and robust community partnerships fuels a culture where every team member is empowered to make a tangible difference in the lives of the individuals we serve.

Why This Role Matters – The Heartbeat of Our Service Delivery

The Medicaid Eligibility Specialist is the linchpin that connects patients with the financial resources they need to access Freedom Care’s premium services. By expertly navigating Pennsylvania’s Medicaid landscape—eligibility criteria, spend‑down requirements, and recertification cycles—you will expedite enrollment, protect continuous coverage, and ensure that our clients receive the care they deserve without interruption. In short, your work directly influences the speed, efficiency, and quality of care delivery, making you an essential partner in our mission to bring “dignity and support” to every home.

Key Responsibilities – What Your Typical Day Looks Like

Medicaid Eligibility & Client Guidance

• Provide clear, empathetic explanations of Medicaid eligibility requirements, benefits, and spend‑down thresholds to prospective and existing clients.
• Respond promptly to client inquiries via phone, email, or secure messaging platforms, ensuring each interaction reflects our core value of Here For You.
• Identify alternative resources—such as state‑run assistance programs or charitable funds—to bridge gaps when clients fall short of eligibility criteria.
• Conduct educational webinars or one‑on‑one sessions that demystify Medicaid applications, renewal processes, and coverage options.

Medicaid Renewal & Recertification Management

• Monitor renewal timelines for every active client and proactively reach out 30‑45 days before expiration.
• Guide clients through the collection and submission of required documentation, minimizing delays and preventing coverage lapses.
• Maintain a rigorous tracking system in Salesforce to flag upcoming deadlines, overdue renewals, and any anomalies that may affect eligibility.
• Collaborate with legal and compliance teams to ensure all renewals meet state and federal regulations.

Documentation, Data Integrity & Reporting

• Enter, update, and verify client information in Salesforce with a focus on accuracy, confidentiality, and compliance.
• Design and maintain detailed eligibility & spend‑down process reports, providing leadership with actionable insights on enrollment trends, bottlenecks, and success metrics.
• Audit case files on a quarterly basis to guarantee that all documentation aligns with Pennsylvania Medicaid guidelines.
• Develop streamlined templates for eligibility verification that reduce administrative time and improve consistency across the team.

Stakeholder Communication & Advocacy

• Serve as the primary point of contact for Medicaid‑related questions from clients, caregivers, and health‑plan partners.
• Advocate on behalf of clients with government agencies, ensuring their concerns are heard and resolved swiftly.
• Partner with case managers, clinical staff, and billing teams to address coverage discrepancies, appeals, and complex eligibility scenarios.
• Facilitate regular cross‑functional meetings to keep all parties informed of policy updates, program changes, and best practices.

Training, Collaboration & Continuous Improvement

• Lead internal training sessions on Medicaid verification procedures, updates to Pennsylvania regulations, and best practices for client communication.
• Mentor new hires and junior team members, fostering a supportive learning environment aligned with our value of Own It.
• Participate in process‑improvement initiatives, contributing ideas that enhance efficiency, reduce errors, and elevate the client experience.
• Build strong relationships with local government agencies, community organizations, and advocacy groups to stay ahead of policy shifts.

Essential Qualifications – What You Bring to the Table

• Education: Associate’s or Bachelor’s degree in Social Work, Healthcare Administration, Public Health, or a related discipline is preferred.
• Experience: Minimum of 2 years working with Medicaid programs, healthcare benefits coordination, or social services in Pennsylvania.
• Technical Proficiency: Demonstrated ability to navigate case‑management software, preferably Salesforce, and other digital tools used for documentation and reporting.
• Communication Skills: Exceptional verbal and written communication capabilities, with a proven track record of translating complex regulations into understandable guidance.
• Organizational Ability: Strong time‑management and multitasking skills, ensuring timely renewals and accurate record‑keeping.
• Interpersonal Competency: Ability to work collaboratively with diverse populations, including seniors, caregivers, healthcare professionals, and governmental staff.
• Analytical Mindset: Comfort analyzing intricate eligibility data, identifying trends, and making evidence‑based decisions.

Preferred Extras – Skills That Set You Apart

• Professional certification such as Certified Medicaid Specialist (CMS) or Certified Health Care Access Professional.
• Experience conducting virtual training sessions or facilitating community outreach programs.
• Familiarity with Pennsylvania’s spend‑down methodology and income‑based eligibility calculations.
• Fluency in a second language (e.g., Spanish) to better serve multicultural client bases.
• Background in data analytics or reporting tools (e.g., Tableau, Power BI) to enhance performance dashboards.

Core Competencies for Success

• Empathy & Service Orientation: Live our Here For You value by demonstrating genuine care and a “can‑do” attitude toward client challenges.
• Integrity & Accountability: Uphold the Do the Right Thing principle, ensuring compliance with all federal and state regulations.
• Positive Mindset: Maintain optimism and resilience, especially when navigating complex eligibility scenarios.
• Detail‑Oriented Execution: Precise documentation and rigorous follow‑through are essential to avoid coverage gaps.
• Collaborative Spirit: Work seamlessly across departments, embodying the Own It mentality to drive shared outcomes.

Career Growth – Your Pathway at Freedom Care

Freedom Care invests heavily in the professional development of its employees. As a Medicaid Eligibility Specialist, you will have access to:

• Structured mentorship programs pairing you with senior compliance or operations leaders.
• Continuing education stipends for certifications, conferences, or relevant coursework.
• Opportunities to transition into senior roles such as Medicaid Program Manager, Compliance Analyst, or Operations Team Lead.
• Cross‑functional projects that broaden your exposure to finance, technology, and strategic planning within the organization.
• Regular performance reviews that include personalized development plans and clear promotion pathways.

Our Culture – A Place Where Every Voice Matters

At Freedom Care, we celebrate diversity, foster inclusion, and nurture a supportive environment where employees feel valued and heard. Our culture is built on four pillars:

• Collaboration: Open‑door communication, cross‑team brainstorming sessions, and shared success celebrations.
• Innovation: Encouragement to propose technology‑driven solutions that streamline eligibility workflows.
• Wellness: Access to mental‑health resources, wellness challenges, and flexible scheduling to promote work‑life balance.
• Community Impact: Volunteer days, partnership with local non‑profits, and employee‑led outreach initiatives.

Compensation & Benefits – What We Offer

While exact figures will be discussed during the interview process, you can expect a competitive salary benchmarked against industry standards for entry‑level Medicaid roles, coupled with a comprehensive benefits package that includes:

• Medical, dental, and vision insurance with multiple plan options.
• Employer‑matched 401(k) retirement savings plan.
• Paid time off (PTO), holidays, and sick leave.
• Remote‑work stipend for home‑office setup and internet costs.
• Professional development budget for certifications and coursework.
• Employee assistance program (EAP) for personal and professional support.
• Health and wellness incentives such as gym membership discounts and mindfulness workshops.

How to Apply – Take the Next Step Toward a Meaningful Career

If you are driven by a desire to help vulnerable populations navigate complex healthcare systems, thrive in a hybrid environment, and are eager to grow within a forward‑thinking organization, we want to hear from you. Even if you feel you don’t meet every single requirement, we encourage you to apply—your unique perspective could be exactly what our team needs.

Ready to Make an Impact?

Click the link below to submit your application, attach your resume, and share a brief cover letter outlining why you’re passionate about Medicaid eligibility and how your experience aligns with our mission.

Apply Now – Join Freedom Care’s Medicaid Eligibility Team

Join Us and Be Part of Something Bigger

Freedom Care isn’t just a workplace; it’s a community of dedicated professionals committed to delivering dignity, support, and high‑quality care to patients in their homes. By becoming a Medicaid Eligibility Specialist, you will play a pivotal role in safeguarding access to essential health services for thousands of Pennsylvanians. We look forward to welcoming a compassionate, detail‑oriented, and enthusiastic individual into our vibrant family.