Medicaid Specialist

Position Summary 

Ace Care Management’s mission is to provide excellent and unmatched health care management to individuals and families governed by a seamless collaboration of all stakeholders. The Medicaid Specialist contributes to this mission by being responsible for assisting members with enrollment issues related to Medicaid waiver programs and ensuring compliance with state regulations. This role requires in-depth knowledge of the Elderly and Disabled Waiver Program (EDWP) in Georgia, specifically focusing on the Medicaid side of both CCSP (Community Care Services Program) and SOURCE (Service Options Using Resources in a Community Environment). Additionally, the Specialist should be well-versed in Aged, Blind, and Disabled (ABD) Division of Family and Children Services (DFCS) operations and Medicaid eligibility requirements to effectively guide members through the application and enrollment process. 

Primary Duties and Responsibilities 

• Assist members in understanding and enrolling in Medicaid waiver programs, including CCSP, SOURCE, and other home- and community-based services. 

• Provide detailed information and guidance on the Elderly and Disabled Waiver Program (EDWP), ensuring members understand the eligibility criteria, application processes, and required documentation. 

• Work closely with members and their families to guide them through the Medicaid application process, ensuring all necessary documents and verifications are submitted accurately and on time. 

• Collaborate with different DFCS districts across Georgia to streamline the Medicaid application process, track applications, and address any issues that may arise. 

• Ensure that SOURCE members who lose Medicaid coverage are quickly transferred to CCSP to prevent disruption in services. 

• Maintain thorough knowledge of ABD DFCS operations, Medicaid eligibility processes, and case management procedures. 

• Monitor Medicaid eligibility status for enrolled EDWP members, proactively resolving any issues that could impact continued care. 

• Stay updated on policy changes related to Medicaid and waiver programs in Georgia. 

• Document all member interactions and maintain accurate records to ensure compliance with organizational and regulatory standards. 

• Provide outreach and educational sessions to members and caregivers regarding benefits, enrollment, and available resources. 

Qualifications 

Required 

• Bachelor's degree in social work, Healthcare Administration, Public Health, or a related field preferred; equivalent experience may be considered. 

• Minimum of 2-3 years of experience in Medicaid waivers, ABD DFCS operations, or healthcare services. 

• Comprehensive knowledge of Georgia’s Elderly and Disabled Waiver Program (EDWP), ABD Medicaid processes, and DFCS case management procedures. 

• Strong interpersonal and communication skills, with the ability to explain complex information clearly to members and caregivers. 

• Proficiency in Microsoft Office Suite and experience with electronic data systems and case management software. 

• Ability to work independently and as part of a team while managing multiple tasks efficiently. 

Preferred 

• Experience working with the Georgia Division of Family and Children Services (DFCS) or similar agencies. 

• Familiarity with the Medicaid application process and eligibility requirements in Georgia. 

• Bilingual abilities are a plus.