Job Description
Job Description
Overview
The Medicaid Support Manager leads the Medicaid Support Team and serves as the organization’s subject matter expert on Medicaid eligibility, enrollment, and hospital claims processes. This role builds and manages workflows that help field teams submit, track, and resolve Medicaid applications while partnering with operations, utilization management, and claims to ensure eligible costs are reimbursed. The Manager also monitors regulatory changes, tracks key performance metrics, and keeps leadership informed of risks, trends, and opportunities.
Responsibilities
- Serve as the organization’s expert on Medicaid eligibility and enrollment
- Monitor Medicaid policy and process changes and communicate impacts to leadership
- Build and manage workflows that support field teams in submitting and tracking Medicaid applications
- Partner with field, operations, utilization management, and claims teams to ensure eligible costs are reimbursed
- Track, maintain, and share key performance metrics to measure effectiveness and outcomes
Qualifications
Education
- Bachelor’s degree required, MBA preferred.
Experience
- Knowledge of State Medicaid eligibility and enrollment guidelines and understanding of hospital claims processing practices.
Licenses/Certifications
- None required