Full-time, hourly, non-exempt. Medi-Cal/CenCal experience is required.
We are seeking a CenCal Enrollment Specialist to join our agency. The CenCal Enrollment Specialist will be a key part of our continued efforts to provide holistic human services to our clientele.
Position Summary:
New Beginnings is seeking a qualified and experienced CenCal Enrollment Specialist to provide comprehensive support for the Enhanced Care Management (ECM) and Community Supports (CS) programs under our CenCal initiative. The CenCal Enrollment Specialist will provide support in conjunction with the Authorization Specialist and Billing Specialist to ensure that all ECM and CS activities are effectively managed, including utilization management, member assignment, and reporting. This role requires a deep understanding of Medi-Cal and CenCal processes, and the ability to optimize service delivery while ensuring compliance with all relevant regulations and standards.
Key Responsibilities:
• Client Enrollment: Ensure all homeless services clients are enrolled in CenCal as eligible and appropriate. Process all enrollment paperwork.
• Eligibility Tracking: Work with homeless services staff to ensure that all clients remain eligible for assistance as appropriate, and update and track their eligibility, ensuring no lapse in coverage,
• Case Note and Service Quality Control: Review all staff case management notes for sufficient and appropriate service provision. Ensure case notes reflect accurate treatment and interventions and meet the standard for service reimbursement.
• Expiring Authorization Tracking: Work with CenCal and case management staff to track authorizations and ensure re-authorizations are submitted.
• Process Optimization: Optimize internal and external CenCal processes, making recommendations for improvements to enhance service delivery and program efficiency. Streamline processes for Caseworkers while aligning with CenCal guidelines.
• Documentation and Reporting: Review case notes for all claims made and related documentation in the Health Management Information System (HMIS). Assist in tracking authorizations and reauthorizations and assist with claims reviews as necessary to ensure accurate and timely billing.
• Quality Improvement: Participate in internal and external meetings as necessary. Provide suggestions for quality improvement initiatives to enhance the effectiveness of ECM and Community Supports programs.
• Additional Duties: Perform other duties as assigned by supervisors to support the successful implementation and operation of the CenCal initiative.
Qualifications:
Education:
• Bachelor’s degree preferred but not required.
Experience:
• Minimum of 1-2 years of experience working with Medi-Cal/CenCal systems management.
• Experience in reviewing care coordination tasks.
• Proven track record in implementing CenCal or similar healthcare programs preferred.
• Familiarity with utilization management, provider oversight, and billing processes in a healthcare setting.
Skills and Competencies:
• In-depth knowledge of Medi-Cal, the CenCal Portal, and the needs of the Medi-Cal member population.
• Strong team player with the ability to work cohesively and collaboratively with a variety of stakeholders.
• Excellent written and verbal communication skills.
• Strong organizational, time-management, and multitasking skills with the ability to set priorities, meet deadlines, and follow through.
• High level of accuracy and attention to detail, with the ability to analyze complex data, review documentation, and track program performance.
• Ability to work unsupervised in the field for part of a shift, with a commitment to ending homelessness through employment.
• Familiar with client intake and assessment.
• Proficiency in PC computer systems, Microsoft Office (word processing and data entry), databases, and relevant software. Experience with HMIS or other care management software preferred but not required.
• Adherence to laws regarding confidentiality and reporting requirements, maintaining current knowledge of HIPAA certification standards, and upholding professional conduct, attitude, and appearance always.
• Possession of a valid driver's license and an insured, registered vehicle at the time of application, and a valid California Class C Driver's License at the time of appointment.
Work Environment:
This is a full-time, on-site position located at New Beginnings’ main office in Santa Barbara, with travel up to Mid and North County offices as needed. The Enrollment Specialist will work closely with the SPP Director, our CenCal team, ECM and Community Supports providers, our data analyst, individual program Directors, and various internal departments to ensure the successful implementation of CenCal initiatives.
Work hours are Monday - Friday, 9:00 a.m. - 5:30 p.m., although there may be occasional nighttime and weekend hours to attend community events or attend to emergent client and administrative needs.
Starting salary is $30-$32 per hour DOE with medical and dental benefits provided, 403b contribution and matching, as well as generous paid time off. Position begins asap.
Application Process:
Interested candidates are encouraged to submit a resume, cover letter, and a list of three professional references to hr@sbnbcc.org. If we feel you are a good match for the position, you will be contacted to schedule an interview.
New Beginnings is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, disability, or protected veteran status.
