PACE Eligibility Navigator

Job description

Position Summary: Under the supervision of the PACE Eligibility Supervisor, the PACE Eligibility Navigator supports the enrollment and retention of participants in San Diego PACE by ensuring accurate and timely verification of Medi-Cal and Medicare eligibility. This position works collaboratively with internal departments, external partners, PACE participants and their family members and state agencies to resolve PACE participant eligibility issues. Assist with new and retroactive enrollments to ensure participants can gain or maintain coverage. The navigator serves as a subject matter expert in state and federal health coverage guidelines and plays a key role in maintaining compliance and data integrity. Essential Functions of the Job: - Initiates and monitors health coverage redetermination/renewal process for patients. Completes Medi-Cal Renewal Package. Reports on all changes in active accounts, Medi-Cal Add-Ons, Referrals. - Assists individuals in applying for and retaining health coverage by collecting necessary and accurate personal and demographic information; conducting home, daycare, or facility visits to determine eligibility; assessing needs; providing accurate informat...