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Specialist, Eligibility-Masshealth (Remote)-Must reside in MA

June 10, 2026

JOB DESCRIPTION Job Summary Provides support for eligibility activities including screening of candidates and identification of qualified, eligible prospects for both long-term care. Assists current members with coverage renewals - ensuring that program participants are enrolled in and maintain applicable benefits and entitlements, and facilitates outreach to prospects who may qualify coverage.Essential Job Duties • Conducts candidate pre-screening for eligibility, and assists prospects/members with eligibility and coverage. • Participates with the care team in continuous performance improvement activities, facilitates performance improvement problem-solving, and contributes to superior customer service team efforts - ensuring every member is treated with respect, courtesy and fairness. • Educates and provides assistance to members and/or families, and completion/submission of recertification applications for potential and active members via telephone and home visits. • Assists members with the recertification package. • Educates/verifies and gathers budget information, and documents accordingly for members who have surplus or pooled trust. • Conducts home visits to assist in completion of documents as needed. • Submits documentation to state agencies within specified time-frames - ensuring participant coverage. • Tracks eligibility status via the state agency system and hotline for all prospect and active members; assists internal teams with verification of Medicaid eligibility through the state agency enrollment system. • Monitors recertification time frames for each active member and maintains records on coverage status and recertification. • Documents all member contacts and completes documentation related to recertification in appropriate systems. • Notifies member of upcoming loss of eligibility and assists in safe transition for disenrollment. • Maintains the highest level of integrity, courtesy, and respect while interacting with prospects and active members, employees and business contacts.Job Requirements • At least 2 years of experience in health care - preferably eligibility, screening, application processing, review, and/or recertification, or equivalent combination of relevant education and experience. • Experience in one or more of the following areas: health insurance, home care, acute or sub-acute care, or long-term care. • Knowledge of current community health practices. • Proficiency navigating the internet and multi-tasking within multiple software/electronic documentation systems simultaneously. • Interpersonal and customer service skills. • Decision-making skills. • Organizational and time-management skills; ability to manage simultaneous projects and tasks to meet internal deadlines. • Technical skills in e-faxing, electronic archiving or encryption. • Effective verbal and written communication skills. • Microsoft Office suite and applicable software programs proficiency. To all current Molina employees. If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...