Job Description

Join Our Team as a Pending Program Specialist – Medicaid Help Individuals Access Essential Healthcare Benefits Creative Solutions in Healthcare is seeking a Pending Program Specialist – Medicaid to join our growing team! In this role, you will play a vital part in expediting Medicaid applications for individuals awaiting approval. You will serve as a liaison between applicants, healthcare providers, and Medicaid agencies to ensure timely processing and reduce delays in care access. Your Impact as a Pending Program Specialist – Medicaid In this role, you will:

• Manage Pending Cases: Track and oversee a caseload of pending Medicaid applications, ensuring timely progress and addressing potential delays.
• Review Documentation: Assess applicant paperwork to confirm completeness and compliance with Medicaid eligibility requirements.
• Communicate with Stakeholders: Maintain regular contact with applicants, healthcare providers, and Medicaid offices to provide updates, request missing information, and resolve concerns.
• Determine Eligibility: Evaluate applicant qualifications based on income, medical needs, and other key factors, identifying potential issues that may impact approval.
• Problem-Solve Application Challenges: Navigate administrative processes, advocate for applicants, and escalate complex cases as needed.
• Maintain Accurate Records: Document interactions, updates, and case statuses within Medicaid systems for accurate reporting and compliance.
• Ensure Regulatory Compliance: Adhere to all Medicaid policies, regulations, and guidelines throughout the application process.

What Makes You a Great Fit We’re seeking someone who:

• Has 5+ years of experience applying HHSC MEPD policy (such as MES II or III, BST I / II Trainer, Case reader).
• Possesses excellent communication and interpersonal skills to engage with diverse individuals.
• Is detail-oriented and highly organized to manage multiple cases efficiently.
• Demonstrates problem-solving abilities to navigate complex cases and advocate for applicants.
• Is proficient in computer systems and data management tools to maintain accurate records.

Why Choose Creative Solutions in Healthcare? As one of Texas’s largest and most trusted providers of long-term care, we are committed to fostering a supportive workplace for our employees. We offer (for full-time employees):

• Comprehensive Benefits: Health, Dental, and Vision Insurance
• Extra Protection: AD&D, Short-Term Disability, Cancer, Critical Illness, and more
• Life Insurance: Whole and Term Policies
• Professional Growth: Tuition Reimbursement for continued education
• Time to Recharge: Paid Time Off
• Retirement Planning: Immediate 401(k) eligibility
• Unwavering Support: Exceptional corporate resources and leadership

Equal Opportunity Employer We are committed to fostering an inclusive workplace. Discrimination or harassment based on race, color, religion, sex, age, national origin, disability, genetics, veteran status, sexual orientation, gender identity, or any other protected characteristic is strictly prohibited.

Job Tags

Full time, Temporary work, Immediate start,

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