Eligibility Continuity Specialist

5 days ago


Rancho Cucamonga, California, United States Inland Empire Health Plan Full time

Job Summary: We are seeking an Eligibility Continuity Specialist to provide full Redetermination of Eligibility (RE) application assistance to IEHP Members to help maintain their Medi-Cal eligibility.

Key Responsibilities:

  • Conduct outbound calls to IEHP Members to help them understand the Medi-Cal Redetermination of Eligibility (RE) process and complete the RE application upon Members request.
  • Help Members prepare and submit any documentation required for the purpose of eligibility maintenance.
  • Develop a thorough understanding of the Medi-Cal eligibility process and resources offered by the state, county, and within IEHP, including BenefitsCal.com and reporting tools.
  • Provide best customer services that reflects our MVV to IEHP Members.
  • Proactively identify opportunities for improvements, including frictionless processes.
  • Document call results in a Customer Relationship Management (CRM) database.
  • Document and submit information using an online portal.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.



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