Medicaid Eligibility Specialist

FEDlogic, LLC

Medicaid Eligibility Specialist guiding clients and customers through complex Medicaid eligibility rules. Analyzing cases and supporting compliance with state and federal regulations.

Posted 7/15/2026full-timeRemote • 🇺🇸 United StatesSeniorLead💰 $52,000 - $65,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Expertise in Medicaid eligibility rules and policy analysis, with a strong focus on stakeholder engagement and training development. Proven ability to interpret regulations and provide technical assistance in complex eligibility scenarios.

Highest-signal resume keywords

Medicaid Eligibility DeterminationPolicy AnalysisCustomer Relationship Management SystemsAnalytical SkillsStakeholder Engagement

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Medicaid Eligibility RulesMAGIABDMedically NeedyWaiver Programs1634 State Model209(b) State ModelSpend-Down ProgramsEligibility SystemsQuality Assurance

Soft Skills

Strong Writing SkillsCommunication SkillsDetail OrientedCustomer ServiceTraining Development

Tools & Technologies

SalesforceTableauGoogle WorkplaceSlackMicrosoft Office Suite

Industry Keywords

CMS GuidanceState and Federal RegulationsHealthcare NavigationBenefits AdministrationCase Management

Tech Stack

Tools & technologies

Tableau

About the role

Key responsibilities & impact

Serve as a subject matter expert on Medicaid eligibility rules, including MAGI, ABD, Medically Needy, and waiver programs.
Analyze complex eligibility cases and provide technical assistance to internal and external stakeholders.
Interpret and apply state and federal regulations, CMS guidance, and waiver provisions to real-world eligibility scenarios.
Support system design, testing, and policy implementation related to Medicaid eligibility.
Develop and deliver training and reference materials for eligibility workers, supervisors, and partners.
Assist in quality assurance efforts by conducting case reviews and identifying policy gaps or training needs, when needed.
Liaise with our customers and state and federal agencies on eligibility policy clarifications and updates.
Any other tasks as assigned by Leadership.

Requirements

What you’ll need

Minimum 10 years of direct experience in Medicaid eligibility determination, policy analysis or training.
Minimum 3 years of customer service, healthcare navigation, benefits administration, or case management experience.
Deep understanding of Medicaid eligibility rules under SSA, CMS, and state-specific implementations.
Demonstrated experience with 1634 and 209(b) state models, spend-down programs and eligibility systems.
Strong analytical and documentation skills and be detail oriented.
Strong writing, communication, and stakeholder engagement skills.
Experience working in a fast-paced, service-oriented environment.
Prolonged sitting and computer work.
Must be able to handle confidential sensitive medical information.
Proficiency with Customer Relationship Management systems (i.e. Salesforce and Tableau), workforce management tools, Google Workplace, Slack and minimal usage of Microsoft Office Suite.

Benefits

Comp & perks

Flexible remote work environment
Paid Time Off (PTO) plus all federal holidays off
Comprehensive benefits package with health, dental, vision insurance group term life, short term disability, long term disability and voluntary life plans.
Numerous supplemental plans to assist employees.
Paid maternity, paternity and adoption leave benefits.
Cancer Experts Now - supplemental plan
401(k) retirement plan with matching contributions.
Supportive and collaborative work environment.
Opportunity to be part of a rapidly growing company dedicated to making a difference in the lives of families.