Job Opening for Medicaid Eligibility Director in CommuniCare Health Services Corporate (Cleveland, OH)

CommuniCare Health Services is a fast-growing provider of long term care with over 90 facilities located in 7 states. CommuniCare is dedicated to our goal of creating Caring Communities where staff, residents and families join hands to overcome their daily challenges. We are currently recruiting an experienced leader to assume the position of Corporate Medicaid Eligibility Director.

The Medicaid Eligibility Director is responsible for overseeing the Medicaid Eligibility process for all facilities. With expectation of driving positive impact to cash collections by maintaining a high conversion rate. The position has the option to work remotely and will ideally be based anywhere in the state of Ohio.

JOB EXPECTATIONS & ACCOUNTABILITIES:

Oversee and manage the Medicaid Eligibility process for all facilities. Lead efforts on hearings and second level appeals. Drive high level of conversion from Pending to active Medicaid.
Matrix supervision and support for Medicaid Eligibility team members. Including, Regional Medicaid Liaisons and Home Office Medicaid Specialists
Work with Regional and Divisional staff to mitigate financial risk associated with the Medicaid Eligibility process
Regularly provide communication and education to the field regarding regulatory changes
Coordinate with Admissions and Operations on difficult to place admission referrals
Oversee contracts with outside law firms utilized for guardianships and application appeals
Communicate trending concerns by distributing weekly/monthly reports
Monitor Medicaid Pending conversion dollars and timelines
Establish/Maintain relationships with state agencies responsible for the Medicaid Eligibility process
Develop plans to maintain/reduce Medicaid eligibility conversion timelines
Complete training and address issues in the field as needed
Develop and implement policy/procedure and processes as the need is identified
Escalate issues to Corporate VP- Revenue Cycle

QUALIFICATIONS

Knowledge of state and federal regulations pertaining to Medicaid Eligibility
5+ years LTC Medicaid eligibility experience
4 years advanced education beyond high school, or comparable work experience
3+ years of multi facility management experience
Professional appearance and mannerisms
Ability to work as part of a team
Computer skills including, but not limited to Microsoft Word, Excel, and Outlook