Prime Healthcare · 6 days ago
Medicaid Eligibility Manager
DFW Metroplex
Full-time
Onsite
Senior Level
5+ years expPrime Healthcare is an award-winning health system headquartered in Ontario, California, seeking a Medicaid Eligibility Manager. This role is responsible for overseeing the Medicaid enrollment and eligibility process, ensuring uninsured and underinsured patients are effectively screened and enrolled into assistance programs while leading a team of eligibility specialists.
Health CareHospital
Responsibilities
Lead, train, and supervise Medicaid eligibility staff to ensure accurate and efficient enrollment of patients
Oversee the daily operations of the Medicaid eligibility and enrollment process, including application submissions, follow-ups, and approvals
Develop and maintain policies and procedures that ensure compliance with federal, state, and local Medicaid regulations
Screen Patients for financial aid and SSI
Monitor and report on Medicaid enrollment metrics, patient conversion rates, and financial impact
Partner with case management, social work, patient financial services, and clinical teams to identify eligible patients early in the care process
Act as a liaison between the hospital, state Medicaid offices, and external vendors to resolve application or eligibility issues
Stay current with changes in Medicaid rules, eligibility criteria, and healthcare policies; communicate updates to staff and leadership
Provide ongoing staff training and education to maintain high-quality service and compliance
Ensure the department meets or exceeds key performance indicators (KPIs) related to patient enrollment and financial recovery
Support patients and families with compassion and professionalism, ensuring they understand the eligibility process and available options
Qualification
Required
5+ years experience in Patient Advocacy/Medicaid Eligibility & Enrollment
Preferred
Bachelor Degree preferred
Company
Prime Healthcare
About Prime Healthcare and Prime Healthcare Foundation: Prime Healthcare is an award-winning health system operating 51 hospitals and more than 360 outpatient locations in 14 states, providing over 2.5 million patient visits annually.
10001+ employees
Funding
Current Stage
Late StageTotal Funding
$1.5B2024-09-04Debt Financing· $1.5B
Leadership Team
Luis Leon
Chief Operating Officer, Chief Executive Officer Region VI
Recent News
2026-01-16
2026-01-12
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