About this opportunity
POD Health lists this Patient Benefits Manager (Medicaid Experience Required) opportunity in new york, New York. Review the employer’s description below for duties, qualifications and application requirements.
Job description
About POD Health
At POD Health, we improve patient outcomes by combining technology with personalized, accessible care. Our integrated clinical and support services help patients manage their health while addressing barriers that may affect their ability to receive and maintain appropriate care.
As POD Health continues to expand, our Social Services Coordination (SSC) team plays an increasingly important role in helping patients navigate healthcare benefits, government programs, community resources, and other services that support their health and well-being.
Position Summary
POD Health is seeking an experienced Manager of Patient Benefits to lead and develop our growing Social Services Coordination team.
This individual will serve as a subject matter expert in Medicaid eligibility, patient benefits, government assistance programs, and community resource navigation. The Manager will provide hands‑on guidance and training to the SSC team, assist with complex patient cases, develop standardized workflows, and ensure patients are connected with appropriate resources in a timely and compliant manner.
The ideal candidate has significant experience with Medicaid applications, renewals, recertifications, spend‑down cases, pooled income trusts, case corrections, code removals, eligibility issues, and other complex Medicaid matters that may otherwise require outside Medicaid consulting support.
Beyond New York expertise, this individual will help POD Health build its patient resource infrastructure as the organization expands into additional states, including Florida and Colorado — researching state‑specific Medicaid programs, benefits, community resources, and referral organizations, and translating those findings into practical workflows for the team.
This is a leadership and subject matter expert position for someone who can not only manage a team, but teach that team to handle increasingly complex patient needs independently.
Key Responsibilities
Team Leadership & Development
Lead, supervise, coach, and develop the Social Services Coordination team
Serve as the team's primary subject matter expert for complex Medicaid, benefits, and social‑service cases
Provide structured training, case reviews, mentorship, and ongoing education
Develop training materials, reference guides, standard operating procedures, and escalation pathways
Review difficult or unusual cases with staff and provide clear recommendations for next steps
Support performance management while maintaining a collaborative, educational, patient‑centered team environment
Identify knowledge gaps and create targeted training to improve team capabilities
Medicaid & Benefits Expertise
Provide advanced support for Medicaid‑related matters, including:
Applications and enrollment
Renewals and recertifications
Eligibility verification
Spend‑down and excess‑income cases
Pooled income trust coordination
Case corrections
Code removals and restriction issues
Coverage reinstatement
Coverage gaps and eligibility discrepancies
Changes in income, assets, household composition, or residency
Medicaid managed care issues
Long‑term care and home‑care Medicaid pathways
Coordination with Medicaid agencies, managed care organizations, and other governmental entities
Review complex cases that would traditionally require referral to an outside Medicaid consultant, and determine when external legal or specialized assistance remains necessary.
Patient Benefits & Resource Navigation
Oversee and support the team's work connecting patients with services such as:
Home care and long‑term care resources
Medicaid and other insurance programs
SNAP and food assistance programs
Transportation assistance
Housing and utility resources
Durable medical equipment and related benefits
Personal emergency response and safety resources
Adult day and community‑based programs
Financial assistance programs
Government benefits
Community and nonprofit organizations
Other health‑related social needs identified by patients or the clinical team
Maintain and continuously improve an organized resource library for the SSC team.
Multi‑State Program Development
Research Medicaid programs, government benefits, community organizations, and patient assistance resources in states where POD Health operates
Develop state‑specific resource directories and workflows for New York, Florida, and Colorado
Identify differences in eligibility requirements, application processes, available benefits, and referral pathways between states
Establish relationships with governmental agencies, community organizations, managed care plans, and other resource partners
Train SSC staff on state‑specific programs and escalation procedures
Support leadership with operational planning as POD Health expands into additional markets
Case Oversight & Quality Assurance
Review complex, delayed, or escalated patient cases
Conduct regular audits of case documentation, follow‑up activity, outcomes, and timeliness
Ensure each case has a clearly documented status, next action, responsible party, and follow‑up plan
Identify recurring barriers and develop operational solutions to prevent delays
Monitor unresolved cases and assist staff with escalation when necessary
Ensure appropriate documentation and confidentiality standards are maintained
Workflow & Program Development
Evaluate existing SSC workflows and identify opportunities for improvement
Develop standardized processes for common patient benefit and social‑service needs
Establish clear criteria for when cases should remain with an SSC, be escalated to management, or be referred to an outside specialist
Partner with leadership to reduce dependence on outside Medicaid consultants by building internal expertise
Develop tools, templates, checklists, and standardized documentation practices
Help define meaningful productivity, quality, and patient‑outcome metrics for the department
Interdepartmental Collaboration
Partner with clinical, care management, operations, billing, compliance, and leadership teams to address patient barriers to care
Serve as a resource to staff when Medicaid or benefit issues affect a patient's ability to receive services
Communicate significant policy or program changes to leadership and affected departments
Participate in cross‑functional initiatives aimed at improving patient access and continuity of care
Regulatory & Program Knowledge
Maintain current knowledge of Medicaid regulations, eligibility requirements, government benefit programs, and relevant state and federal changes
Translate regulatory and program changes into practical guidance for frontline staff
Ensure departmental processes remain consistent with applicable requirements and organizational policies
Qualifications
Required
5-7 years of direct experience with Medicaid eligibility, government benefits, social services, healthcare navigation, or a closely related field
2-3 years of supervisory, management, training, or senior‑level case oversight experience
Strong working knowledge of New York Medicaid eligibility and enrollment processes
Demonstrated experience handling complex Medicaid cases, including applications, recertifications, spend‑down, pooled income trusts, eligibility corrections, code removals, reinstatements, and coverage issues
Experience working with Medicaid eligibility systems and government benefit portals
Strong understanding of healthcare and community resources available to older adults, individuals with chronic conditions, individuals with disabilities, and underserved populations
Demonstrated ability to research unfamiliar programs and develop clear operational guidance for others
Strong training and staff‑development skills
Ability to explain complex Medicaid and benefit requirements clearly to employees, patients, and families
Strong organizational, documentation, problem‑solving, and case‑management skills
Ability to independently manage complex cases while developing the capabilities of a growing team
Preferred
Experience in healthcare, managed care, home care, social services, Medicaid consulting, community‑based organizations, or government benefits
Experience supporting patients across multiple states
Familiarity with long‑term care Medicaid and home and community‑based service (HCBS) programs
Experience developing SOPs, training programs, resource guides, and quality assurance processes
Experience working directly with government agencies, managed care organizations, Medicaid offices, or benefits advocacy organizations
Bachelor's or master's degree in social work, healthcare administration, public administration, human services, or a related field — may be substituted with significant relevant professional experience
Benefits
Health, dental, and vision insurance
401(k) with company match
PTO and paid holidays
Professional development opportunities
Mission‑driven work in an innovative healthcare space
Ideal Candidate
The ideal candidate is an experienced Medicaid and patient‑benefits professional who enjoys teaching others and solving complex cases. They should be comfortable stepping into a growing department, evaluating current processes, developing staff expertise, building resources for new markets, and serving as the team's trusted resource when a patient situation becomes difficult or unfamiliar.
Success in this role will be measured not only by individual case resolution, but by how effectively the Manager strengthens the knowledge, independence, consistency, and overall capabilities of the SSC team.
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Worksite address
new york, NY, 10261, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.