MassHealth Enrollment Specialist

Who we are

At Entyre Care, we’re on a mission to empower everyone to live with dignity and independence in the comfort of their own home. We’re passionate about supporting friends and families who provide home care for their loved ones. Our offerings include professional training, fair compensation, and the tools they need to thrive to create a safe and respected environment for those they care most about. 

Entyre Care is a progressive, high growth, startup organization that centers around Adult Foster Care (AFC). We use cutting edge technology to further the advancement of healthcare in a home care setting. We’re always looking for motivated, empathetic, and value-driven people to join our supportive team.  

Caring for someone you love shouldn’t feel overwhelming, which is why we’re here to ensure every caregiver feels confident, supported, and valued. Ready to join our journey? You can learn more about us here at www.entyrecare.com.

Your role as MassHealth Enrollment Specialist

We are seeking our first ever MassHealth Enrollment Specialist to join our team. The ideal candidate will be dedicated and knowledgeable with all things Medicaid and MassHealth, and will possess a strong background in researching member insurance issues, counselling patients on insurance plans, navigating the complexities of MassHealth LTSS services and have a solid understanding of SCO, PACE and MassHealth Waivers. This role is vital in ensuring that our patients receive the best possible insurance solutions tailored to their needs. We’d love to speak to candidates who have CAC certifications or SHINE accredited.

Key Responsibilities:

• Assess and determine MassHealth eligibility for clients, utilising the knowledge of MassHealth LTSS services and the specific benefits associated with various forms of MassHealth.

• Provide guidance and counsel to patients regarding insurance plans, discussing risks and benefits to help them make informed choices.

• Experience with over 65 community and knowledge of SCO

• Engage with patients in their homes to assist with onboarding, ensuring a smooth transition into necessary services.

• Demonstrate a strong understanding of ACO/MCA plans within the Massachusetts health insurance system to aid clients in navigating their options.

• Research member insurance issues, addressing concerns related to benefits and eligibility, and help clients understand their options.

• Familiarize yourself with prior authorization processes related to LTSS and MassHealth services, including hospice services and personal care assistance (PCA).

• Display ambition and innovation in developing patient solutions through insurance options, constantly seeking to improve processes.

• Maintain a self-starter mentality by tracking key quantifiable metrics related to patient enrollment documents to enhance efficiency in the enrollment process.

• Practice keen listening skills to effectively connect with patients during insurance navigation, ensuring their needs are understood and met.

• Communicate effectively with internal staff regarding trends and issues related to insurance enrollment, fostering cooperative problem-solving.

• Minimum of 2 years of experience in MassHealth eligibility and enrollment

• Foundational knowledge in Adult Foster Care and SCO is strongly preferred.

• CAC or SHINE certified

• Experience in the insurance industry is strongly preferred.

• Proven experience with client interaction and willingness to travel to patients' homes.

• Strong interpersonal skills with the ability to engage with diverse populations and build rapport.

• Familiarity with MassHealth LTSS services, including the benefits of various insurance plans.

• Understanding of ACO/MCA plans within the Massachusetts health insurance system.

• General knowledge of prior authorisations in LTSS and services covered under MassHealth.

• Self-motivated and proactive approach to finding innovative solutions for patient needs.

• Strong communication skills to convey information clearly and effectively to patients and internal teams.

So, why should you join Entyre Care?

• You’ll be joining a driven team transforming home care services and empowering caregivers everywhere.

• You’ll have an impact in shaping the future of Entyre Care, leaving your mark on an industry that truly matters.

• Unlocking your full potential for personal and professional growth as you advance your career in a supportive, forward-thinking environment.

Our Benefits and Wellbeing

We believe in taking care of our team as well as taking care of the community around us. Whether you're salaried or hourly - we’ve got you covered! All our employees are entitled to our benefits and wellbeing package, which includes the following:

• 11 paid public holidays and 21 days of PTO, giving you plenty of time to relax, recharge, and share good times with your loved ones

• Approximately 5 days of paid sick leave to take care of yourself when needed

• We offer comprehensive insurance through Blue Cross Blue Shield, and dental, vision, and life insurance with Unum

• You will have access to resources like SoFi for financial wellness, SmartSpend for exclusive discounts, Ladder for health and fitness support, and Fetch for pet care perks

• You will be enrolled into our 401(k) pension plan

• This role has flexibility with a hybrid-working model. There is an expectation to be onsite approximately 3 days a week, at our office over on Atlantic Avenue

• As this role involves home visits to our patients and clients, we’ll provide you with a monthly flat-fee driving allowance

• This role is Monday-Friday, 9.00am - 5.00pm. We offer flexible working hours, too!

Our Commitment to Diversity, Equity, and Inclusion

We’re dedicated to celebrating and building an inclusive workplace where every individual feels valued, respected, and empowered to thrive - and to bring their best selves to work! As an equal opportunity employer, we welcome talented people from all backgrounds and walks of life. Regardless of race, ethnicity, religion, gender, sexual orientation, national origin, disability, or veteran status, we’re here to support you in building a career that matters.

Our office address is 711 Atlantic Ave, Boston, MA 02111. We’re located on the 6th floor of the building. If you are successful in our process and get to visit us here for an onsite interview, our team will make you comfortable and support you with any accessibility challenges.