Enrollment Specialist

Overview:
CareCollab provides Health Home care coordination services to high-utilization Medicaid members with chronic medical and behavioral health conditions. We’re currently seeking a dynamic Enrollment Specialist to engage and enroll eligible individuals in care coordination services and assist with member retention needs. The Enrollment Specialist is responsible for conducting outreach, engagement, and intake activities to enroll eligible individuals into the Medicaid Health Home Program. This role serves as the initial point of contact for prospective members, ensuring they understand program benefits and facilitating a smooth enrollment process.

Key Responsibilities:

• Conduct outreach efforts to identify and engage individuals eligible for the Medicaid Health Home Program, including those with chronic conditions and high healthcare needs.

• Contact potential members through phone calls, community events, home visits, and referrals from healthcare providers or community partners.

• Perform initial assessments and screenings to confirm eligibility and determine healthcare needs.

• Assist individuals and their families with completing enrollment forms and gathering required documentation.

• Collaborate with care coordinators, case managers, and other healthcare professionals to ensure a seamless transition into the Health Home Program.

• Maintain accurate records and documentation in compliance with Medicaid regulations and organizational policies.

• Follow up with individuals to address questions, support their decision-making process, and ensure successful enrollment.

• Support retention efforts by identifying potential barriers to participation and helping members navigate available services.

• Gather, review, and file medical, mental health, and substance use reports from respective providers as needed.

• Represent the agency at various venues to promote agency services.

• Establish and maintain relationships necessary for continued engagement and care coordination services within the community.

Qualifications:

• High school diploma or equivalent required; Associate’s or Bachelor’s degree in healthcare, social work, or a related field preferred.

• Prior experience in outreach, enrollment, or member services within Medicaid, healthcare, or social services.

• Strong understanding of Medicaid programs, community resources, and the needs of individuals with chronic and/or behavioral health conditions.

• Excellent communication, interpersonal, and organizational skills.

• Ability to work independently and collaboratively within a team.

• Proficiency in data entry and basic computer applications.

• Bilingual proficiency in English and another language strongly preferred.

• Familiarity with Health Home Program models and care coordination concepts.

• Field-based and office-based work with travel to community sites, member homes, and healthcare facilities.