LILIA H. ESCANELLE

• Served as subject matter expert for Medicaid/Medicare operational processes impacting dual-eligible and LTSS populations.
• Analyzed CMS guidance and state Medicaid requirements to support compliance and operational alignment.
• Developed internal educational materials to improve staff knowledge of LTSS, HCBS, and D-SNP requirements.
• Collaborated with clinical, UM, appeals, provider relations, and leadership teams to ensure shared understanding of policy impacts.
• Supported workflow redesign and scenario planning using process improvement methodologies.

• Coordinated LTSS and HCBS services for Medicaid and dual-eligible members, ensuring access to necessary care and support.
• Interpreted Medicaid policy, LTSS eligibility criteria, and managed care contract requirements.
• Educated members, families, and providers on LTSS programs and HCBS benefits.
• Supported transitions between institutional care and community-based services.
• Educated members, families, and providers on LTSS programs and HCBS benefits, enhancing understanding and utilization of available resources.

• Coordinated care and administrative processes for aging and disability populations to enhance service delivery.
• Managed documentation, reporting, and communication to ensure compliance with regulatory requirements.
• Collaborated with interdisciplinary teams to address and meet diverse patient needs.

Minor: Organizational Management

Specialization: Healthcare Informatics Systems