Medicaid Case Coordinator

About SPS
SPS helps individuals and families navigate the Medicaid application process for long-term care. We partner with skilled
nursing facilities (SNFs) and long-term care (LTC) providers to assist residents and their families in obtaining Medicaid
coverage for long-term care services.
Position Overview
We are seeking a motivated, personable, and results-oriented Nursing Home Medicaid Coordinator to join our growing
team.

This role combines healthcare coordination, client outreach, relationship management, and sales-oriented
communication. You'll work closely with nursing facilities, clients, county Medicaid offices, and internal teams to identify
potential Medicaid cases, monitor cases throughout the submission and approval process, and resolve issues that arise
after submission.

The ideal candidate is confident communicating with families, healthcare professionals, and Medicaid offices, enjoys
building strong relationships, and is motivated by follow-through, performance, and measurable results.

This position is best
suited for a proactive, organized professional who thrives in a fast-paced environment and takes ownership of their work.
Responsibilities
Facility Census Review & Client Outreach
• Review census reports for all facilities on an ongoing basis
• Identify appropriate residents and determine when outreach calls should be made
• Contact clients and/or responsible parties to discuss services and eligibility
• Evaluate and determine whether cases should be handled as SPS or SPSCS cases
• Maintain strong communication and relationships with facilities, LTC staff, clients,
and intake representatives
• Provide a balance of customer service, relationship-building, and sales-oriented

Medicaid Case Monitoring & Issue Resolution (MCS)
• Monitor and manage Nursing Home Medicaid cases after submission and approval
• Review cases to determine approval status and identify any outstanding issues
• Address and resolve problems that arise after submission or approval in a timely
manner
• Maintain ongoing communication with Medicaid offices, facilities, clients, and
internal departments
• Ensure all follow-ups and documentation are completed accurately and promptly
County Submission Follow-Ups
• Follow up regularly with county offices regarding submitted Medicaid cases
• Build and maintain positive working relationships with Medicaid caseworkers and
supervisors
• Obtain status updates and push cases toward approval efficiently
• Escalate unresolved issues when necessary while maintaining professionalism and
strong county relationships