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Medicaid/Medicare Services Specialist II
Commonwealth of KentuckyUnited StatesRemotefull_timeVerifiedPosted 10 Aug 2026
💰 $64,816/yr($43,210/yr – $64,816/yr)
About the role
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8/20/2026 (11:59 PM ET)
2604174
Medicaid/Medicare Services Specialist II
Pay Grade
14
Salary
$43,210.08 - $64,816.08 Annually
Employment Type
EXECUTIVE BRANCH | FULL TIME | ELIGIBLE FOR OVERTIME PAY | 18A | 37.5 HR/WK
Hiring Agency
Cabinet for Health & Family Services | Department for Medicaid Services
Location
275 E Main Street
Frankfort, KY 40621 USA
Frankfort, KY 40621 USA
Description
The agency may authorize the selected candidate to telecommute as a Hybrid. The agency may terminate or modify
the telecommuting arrangements at any time.
The Department for Medicaid Services (DMS) provides health care access for eligible low-income residents of Kentucky including children, families, pregnant women, the aged and the disabled as well as a number of programs and services directed at specific eligibility and medical needs. DMS strives each day to meet the mission of the Cabinet for Health and Family Services to be a diverse and inclusive organization providing programs, services and supports that protect and promote the health and well-being of all Kentuckians and their communities.
The Division of Health Plan Oversight is responsible for administering and overseeing key healthcare programs that serve Kentuckians. The Division's responsibilities include Medicaid eligibility, oversight of Managed Care Organizations (MCOs) through contract monitoring and compliance, appeal reviews, and administration of the Kentucky Health Benefit Exchange.
This position is located within the Kentucky Health Benefit Exchange Branch, which oversees the operation and management of Kentucky's State-Based Marketplace, kynect. As Kentucky's official health insurance marketplace, kynect provides individuals and families with a single place to apply for health coverage, compare qualified health plans, determine eligibility for financial assistance, and access programs such as Medicaid and the Kentucky Children's Health Insurance Program (KCHIP). The Branch works to ensure Kentuckians have access to affordable, high-quality health coverage and exceptional customer service.
The Medicaid/Medicare Services Specialist II position offers a rewarding opportunity to serve the citizens of the Commonwealth while developing expertise in healthcare eligibility policy and program administration. Employees in this position will have opportunities to participate in training, collaborate with internal and external partners, and attend in-person events with kynectors and Managed Care Organizations to support outreach and program initiatives.
Learn more about us at: https://chfs.ky.gov/agencies/dms/pages/default.aspx
Responsibilities and Duties:
The Department for Medicaid Services (DMS) provides health care access for eligible low-income residents of Kentucky including children, families, pregnant women, the aged and the disabled as well as a number of programs and services directed at specific eligibility and medical needs. DMS strives each day to meet the mission of the Cabinet for Health and Family Services to be a diverse and inclusive organization providing programs, services and supports that protect and promote the health and well-being of all Kentuckians and their communities.
The Division of Health Plan Oversight is responsible for administering and overseeing key healthcare programs that serve Kentuckians. The Division's responsibilities include Medicaid eligibility, oversight of Managed Care Organizations (MCOs) through contract monitoring and compliance, appeal reviews, and administration of the Kentucky Health Benefit Exchange.
This position is located within the Kentucky Health Benefit Exchange Branch, which oversees the operation and management of Kentucky's State-Based Marketplace, kynect. As Kentucky's official health insurance marketplace, kynect provides individuals and families with a single place to apply for health coverage, compare qualified health plans, determine eligibility for financial assistance, and access programs such as Medicaid and the Kentucky Children's Health Insurance Program (KCHIP). The Branch works to ensure Kentuckians have access to affordable, high-quality health coverage and exceptional customer service.
The Medicaid/Medicare Services Specialist II position offers a rewarding opportunity to serve the citizens of the Commonwealth while developing expertise in healthcare eligibility policy and program administration. Employees in this position will have opportunities to participate in training, collaborate with internal and external partners, and attend in-person events with kynectors and Managed Care Organizations to support outreach and program initiatives.
Learn more about us at: https://chfs.ky.gov/agencies/dms/pages/default.aspx
Responsibilities and Duties:
- Assists customers with applications, eligibility determinations, renewals, and changes in circumstance for health coverage programs administered through kynect.
- Reviews and evaluates eligibility information to ensure accurate and timely determinations in accordance with state and federal laws, regulations, and policies.
- Researches complex eligibility and policy issues to identify appropriate resolutions and ensure compliance with established program requirements.
- Responds to customer, provider, stakeholder, and partner inquiries regarding eligibility, enrollment, and health benefit programs through multiple communication channels.
- Provides exceptional customer service while maintaining professionalism, confidentiality, and empathy when interacting with individuals experiencing difficult or stressful situations.
- Interprets and applies federal and state regulations, policies, and procedures to make sound eligibility and program decisions.
- Documents case actions, research findings, and customer interactions accurately and thoroughly within applicable eligibility and case management systems.
- Supports implementation of new policies, procedures, and initiatives related to the Kentucky Health Benefit Exchange.
- Knowledge of eligibility policies for Medicaid, Qualified Health Plans, and other health coverage programs.
- Ability to interpret and apply complex state and federal regulations.
- Strong analytical and problem-solving skills with attention
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