At WelbeHealth, our Outreach and Enrollment Team is the first touchpoint prospective participants have with us. A vital part of WelbeHealth’s PACE enrollment process is aiding those who qualify with the Medi-Cal Enrollment process.

The Medi-Cal Enrollment Specialist focuses on successfully enrolling prospective participants in Medi-Cal. The Medi-Cal Enrollment Specialist is a member of the Marketing, Outreach, and Enrollment (MOE) team and provides back-up and support to Outreach and Enrollment functions as assigned.

Essential Job Duties:

• Gather all necessary documentation to create, submit, doggedly pursue, and appeal Medi-Cal enrollments for prospective participants.
• Visit senior’s homes as needed to gather necessary documentation to submit complete applications
• Maintain a strong working relationship with the Department of Public and Social Services (DPSS) at the county to ensure seamless enrollment workflow, adhere to deadlines and ensure compliance with DHCS and CMS guidelines and policies (for example, marketing guidelines and denials policies)
• Create and conduct Medi-Cal enrollment events to attract prospective participants:
  • Every week in each of the WelbeHealth centers in territory
  • Monthly at senior housing, hospitals, senior centers, churches
  • Monthly virtual enrollment sessions
• Demonstrate in-depth knowledge of Medi-Cal rules, processes, practices, and options to enroll including but not limited to share of cost, spousal impoverishment protections, and appeals processes

Job Requirements:

• Bachelor’s degree in relevant field preferred, an additional five (5) years of relevant Medi-Cal enrollment experience may be substituted
• Bilingual (Spanish/English) strongly preferred
• Minimum of three (3) years of experience working directly with the county DPSS submitting, managing, and appealing Medi-Cal enrollments
• Demonstrated knowledge and experience with complex Medi-Cal enrollment case management

Benefits of Working at WelbeHealth Apply: your Medi-Cal expertise in new ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for.

• Medical Insurance Coverage (Medical, Dental & Vision)
• Work/Life Balance – we mean it! 17 days of Person Time Off (PTO,) 12 paid holidays observed annually, and 6 sick days
• 401k Savings + match
• And additional benefits

The WelbeHealth PACE program helps seniors stay in their homes and communities by providing comprehensive medical care and community-based services. It’s our mission to serve the most vulnerable seniors with better quality and compassion in a value-based model. The Senior Care Advisor helps assess PACE eligibility by fostering relationships with prospective participants, their family members, and their caregivers. A trusted telephonic resource, the Senior Care Advisor helps guide seniors who may qualify for the PACE program through the enrollment process with WelbeHealth.

The Senior Care Advisor will collaborate with market leaders, members of the clinical team, and others to get seniors all the way to enrollment, which may include assisting prospective participants with the Medi-Cal application process. Other tasks will include answering inbound and doing follow-up calls, as well as outbound calls to online leads.

Essential Job Duties:

• Display great patience, empathy, and show “courage to love” on every call; build strong relationships with prospective participants, caregivers and independent outreach associates who may need assistance with participant enrollment
• Support inbound campaigns, answer questions, and find underlining needs of prospective participants, educating them about PACE services and benefits to expand our mission to help more seniors in the communities we serve
• Make outbound calls to prospective participants that have indicated an interest in learning more about WelbeHealth PACE (*not cold calls*)
• Effectively manage leads that require follow-up calls
• Maintain the highest level of service on all calls, both inbound and outbound

Job Requirements:

• Associate’s degree preferred; or two (2) years of relevant experience may be substituted in lieu of degree
• Minimum of one (1) year of experience in tele sales, customer services sales, Medicare or PACE sales experience preferred
• Experience using CRM systems (Salesforce or other similar CRM system)
• Medicare Advantage or PACE experience preferred
• Medi-Cal knowledge preferred

Benefits of Working at WelbeHealth: Apply your sales expertise in new ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for.

• Work/life balance - we mean it! 17 days of personal time off (PTO), 12 holidays observed annually, and 6 sick days
• Medical Insurance Coverage (Medical, Dental, Vision)
• Advancement opportunities - we’ve got a track record of hiring and promoting from within, meaning you can create your own path
• And additional benefits