Archived listing. The details below describe a past opening.
We are looking for an Enrollment Specialist to support CalAIM-related client access, documentation quality, and program compliance in Santa Barbara, California. This Long-term Contract position focuses on coordinating enrollments, monitoring continued eligibility, and helping maintain accurate records that support timely reimbursement and effective service delivery. The ideal candidate brings experience with Medi-Cal or CenCal processes, strong attention to detail, and the ability to work closely with case management and homeless services teams.
Responsibilities:
- Coordinate client enrollment activities for eligible homeless services participants, including preparing, reviewing, and processing required CalAIM and CenCal documentation.
- Monitor ongoing benefit status and collaborate with internal staff to keep client eligibility current, reducing the risk of interruptions in coverage or services.
- Audit case management records to confirm services are documented accurately, interventions are clearly reflected, and notes meet reimbursement and compliance standards.
- Track authorization timelines in partnership with program and care teams, ensuring renewals and follow-up submissions are completed before deadlines.
- Examine claims-related records and supporting documentation in the health information system to help promote accurate billing and complete file maintenance.
- Identify workflow improvements that strengthen operational efficiency while keeping program practices aligned with CalAIM requirements and service expectations.
- Participate in meetings with internal and external partners, contributing recommendations that support service quality and continuous program improvement.
- Provide additional administrative and program support as needed to assist with the ongoing success of CalAIM implementation.
- Bachelor’s degree in social work, psychology, counseling, nursing, public health, business, or a related discipline.
- At least 1–2 years of experience working with Medi-Cal, CenCal, or similar healthcare eligibility and enrollment systems.
- Background in reviewing care coordination activities and evaluating documentation for completeness and accuracy.
- Understanding of CalAIM or comparable healthcare initiatives; direct implementation experience is preferred.
- Familiarity with utilization management, provider oversight, authorizations, and healthcare billing practices.
- Strong computer and data entry skills, with the ability to manage detailed records accurately and efficiently.
- Ability to communicate effectively with multidisciplinary teams while maintaining a high level of organization and follow-through.