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I recently had the privilege to sit down with Vicki Jessup, BeneLynk’s Vice President of Government Relations and Quality Assurance. Vicki is one of those people who instantly impresses you, not just because of her deep knowledge of Medicaid policy and compliance, but because of the energy and heart she brings to her work. With nearly 25 years of experience, she has seen every side of the system, from shaping policy at the state level to driving change in the private sector. What stands out most, though, is how much she cares about making sure members are supported and treated with dignity. Talking with her, it’s clear that her expertise and her passion go hand in hand, and that combination makes a real difference at BeneLynk. In this interview, Vicki shares how her career in Medicaid policy has shaped her work at BeneLynk and the impact of those efforts on compliance, advocacy, and the members we serve.
Me: What first sparked your interest in Medicaid policy, and what kept you passionate about it for nearly 25 years?
Vicki: My first exposure to Medicaid came right out of college when I was working as a case manager for adults with developmental disabilities. That's when I realized Medicaid isn't just a program; it's a lifeline. Medicaid provides hope and dignity to millions of vulnerable Americans. And I've stayed passionate about it all these years because I love the complexity of the policy and because I can use my expertise to help people. I also believe in the program's ability to promote health equity, provide economic security, and deliver a strong return on investment.
Me: How does your background in both state government and the private sector shape the way you approach your work at BeneLynk?
Vicki: My time in state government taught me how policy is made, how systems get designed, and the critical importance of compliance. Working in the private sector gave me valuable insight into the real-world impact of Medicaid on people's lives. These perspectives have enabled me to pursue practical solutions that honor policy intent while making processes more effective and centered on the people that we serve.
Me: What trends are you currently seeing in Medicaid eligibility policy that health plans should pay attention to?
Vicki: States are under significant financial pressure due to decreased federal revenue as a result of the restrictions on provider taxes and state-directed payments. They're also facing complex and expensive implementation of work requirements and more frequent renewals, as well as slowing state revenue growth and rising healthcare costs. All of these pressures are going to increase churn and reduce enrollment stability, which in turn will impact safety net providers (healthcare organizations that deliver healthcare services to vulnerable populations, including the uninsured and those on Medicaid), some of which will likely face closure due to funding shortfalls.
Me: What does a day in the life for you look like at BeneLynk?
Vicki: I start each day by reviewing my schedule and identifying what I can realistically tackle from my to-do list. At the same time, I keep a very close eye on our team's workload to ensure resources are aligned with our most important priorities, and the majority of my time is dedicated to supporting my team of 38 and collaborating with colleagues.
Me: Why is Medicaid eligibility so complicated?
Vicki: Medicaid is a federal-state partnership, which means each state operates its own program within broad federal guidelines. There are 51 distinct Medicaid programs, one for each state as well as D.C., each having its own eligibility criteria, enrollment processes, and covered populations.
Adding to this complexity, Medicaid rules are constantly evolving due to federal policy updates, court rulings, and shifts in state budgets, which requires continuous learning and adaptation.
Me: How do you keep up on all the different pathways to Medicaid in every state?
Vicki: It's not just about understanding Medicaid eligibility pathways. It's also about staying current with application and renewal processes, which are constantly evolving. To try my best to stay up to date, I attend Medicaid Advisory Committee meetings. I monitor state policy memos and handbook updates. I leverage relationships that I have with state and county Medicaid staff and regularly review federal guidance, including state Medicaid director and state health official letters, HPMS memos, state plan amendments, and waiver applications. Ongoing engagement allows me to stay abreast of policy shifts and interpret changes quickly so that we can operationalize them internally and support both our members and our colleagues with accurate and timely information.
Me: In your opinion, what sets BeneLynk apart when it comes to member advocacy?
Vicki: In my opinion, empathy and expertise are what define our approach. Our team truly listens to members and does everything we can to help them navigate complex challenges with confidence and dignity. We pair this compassion with deep Medicaid policy expertise and a strong commitment to helping others. This combination allows us to carefully analyze eligibility decisions, identify errors, and advocate for corrections, so members get the benefits they're entitled to.
Me: How does your work influence product design and innovation at BeneLynk?
Vicki: My background working with eligibility systems like Wisconsin's, as well as former employers' case management systems, gives me a unique perspective when developing business requirements for our system. I approach system design with both the member experience and staff workflow in mind- always considering how design choices impact usability, efficiency, and outcomes. My goal is to help create solutions that not only meet policy and compliance needs but also empower staff to work effectively and support members with clarity and compassion.
Me: Can you share a success story or example that really sticks with you?
Vicki: The ones that stay with me the most are the ones where we create lasting impact, such as when we help influence a state policy change, educate eligibility workers on nuanced Medicaid eligibility rules, or successfully challenge cases where the state applied a more restrictive eligibility criterion for MSP than what’s allowed by SSI. From my perspective, these wins go beyond just that individual case. They create a ripple effect that helps many more people down the line. And then there are all the personal stories. I like to ask members how they plan to use their refund when we know they're getting a big refund because of us challenging an eligibility error. One man told me that he was excited to finally splurge on a new pillow because he hadn't bought one in more than 20 years. I know I can't imagine 20 years without a pillow. Another member told me she was going to use the money to visit her brothers, who she said she hadn't seen in more than a decade. These moments are great reminders of the difference our work makes. It's not just about policy. It's about dignity and improving people’s lives in a meaningful way.
One of our members - it wasn't a case I worked on - knitted a crochet blanket for someone on my team in gratitude for all the help to get her approved. I thought that was just such a lovely gesture.
Me: What do you enjoy most about leading your team?
Vicki: Watching people grow is one of the most rewarding parts of my job. I love seeing team members deepen their understanding of Medicaid eligibility policy, take on new challenges, and succeed in their roles. Supporting their development, whether through coaching, knowledge sharing, or creating opportunities, isn't just fulfilling; it's essential for building a strong, mission-driven team. I'm proud to say that's what we are.
Me: What advice would you give to someone looking to build a career in Medicaid policy or healthcare operations?
Vicki: Building a career in Medicaid policy or healthcare operations is both impactful and intellectually rewarding. These fields are at the heart of healthcare delivery for vulnerable populations in the U.S., and require a blend of policy knowledge, operational acumen, and commitment to public service. To get started, I would recommend learning the fundamentals of the Medicaid program, as well as building relevant education and technical skills, gaining experience in the right settings, networking, and eventually choosing a specialty area. Because Medicaid is constantly evolving, it's important to stay curious, adaptable, and engaged with policy and operational changes. I think those are the keys to long-term success. It's a field where you can make a real difference in people's lives while working on some of the most complex and meaningful challenges in the healthcare system.
Me: If you could snap your fingers and solve one challenge in the Medicaid system, what would it be?
Vicki: Only one? If I could only have one, I would simplify the Medicaid eligibility and enrollment processes. Millions of eligible individuals are delayed, denied, or fall through the cracks because of unnecessary complexity and administrative barriers. These challenges can be made worse by state-level variations and eligibility criteria, documentation requirements, and the use of outdated or fragmented systems. The annual renewal process, especially in the wake of continuous coverage unwinding, exposed how easily people can lose coverage due to missed notices, paperwork issues, or system errors. These procedural disenrollments disproportionately affect vulnerable populations, including seniors and people with disabilities. Streamlining and standardizing eligibility and redetermination across states would reduce churn, improve coverage continuity, and ensure people get the care they need without getting lost in bureaucracy.
Me: What are the most common barriers low-income seniors face when applying for Medicaid?
Vicki: Lack of awareness is a big one. Many people don't even realize they qualify, but other barriers that we see include complex paperwork, confusing state notices, extensive documentation requirements, and having to provide a lot of proof of application answers. There are also language and cultural barriers, immigration concerns, stigma of welfare, mistrust of government, and bureaucratic errors and delays.
Me: How do you handle cases where a senior is just over the income or asset limit?
Vicki: When a member is just over the income limit for the Medicare Savings programs, we typically explore eligibility for Medically Needy Medicaid in the states where that option is available. However, it's important to proactively manage the member’s expectations, particularly when we're confident that their income is over the MSP threshold, so they understand that they're not going to qualify for that, and that spend-down requirements will apply. If a member is slightly over the asset limit, we provide education on allowable strategies to convert the countable assets into exempt assets. Examples of that could include purchasing a prepaid funeral plan or establishing a burial fund if they don't already have one. They could also acquire a small whole life insurance policy within the state limits, and they can also just spend down their excess resources by purchasing necessary household items or any kind of essential goods. Those are all legitimate Medicaid-compliant strategies that can help a member meet asset eligibility without jeopardizing their financial security.
Me: What other programs can benefit our low-income seniors?
Vicki: In addition to Medicaid and the Medicare Savings Programs, low-income seniors can typically also qualify for the Low-Income Subsidy, which is when Medicare Part D pays their premiums and co-pays. Some also qualify for the Supplemental Security Income program through the Social Security Administration, which provides a cash benefit and, in many states, comes
automatically with full Medicaid. Many also qualify for the Supplemental Nutrition Assistance Program (SNAP), formerly known as food stamps, as well as Meals on Wheels, the Low-Income Home Energy Assistance Program (LIHEAP), and the Weatherization Assistance Program.
Me: Does BeneLynk work with these other programs?
Vicki: We absolutely do. We help members access all of these programs and many, many more.
Me: How do you gain trust and build rapport with skeptical and overwhelmed older adults?
Vicki: It takes empathy, patience, and communication. Some of the best practices that my team and I employ are active listening, using plain and simple language, avoiding jargon, being consistent and transparent, and showing cultural and generational awareness. Building trust definitely takes time, but it's essential for making a real difference.
Me: Have you ever encountered a case where Medicaid eligibility was wrongly denied? What did you do?
Vicki: Yes, I would say well over 1000 times throughout my career, we have encountered cases where Medicaid eligibility was wrongly denied. Typically, it's due to a miscalculation of income or assets, or the Medicaid agency failed to notify us as the Medicaid authorized representative, which they're required to do. When we encounter an error, we first try to resolve it through a request for adjusting action with the Medicaid agency. Just simply calling or writing to say, ‘Hey, I think you made a mistake and here's why’. Oftentimes, that does the trick, but if that fails, we will file an appeal and represent the member. In most cases, once they review our appeal request, the Medicaid agency will acknowledge that a mistake occurred, and they'll correct it. However, if a fair hearing is needed, we will represent the member, and we're prepared to go the distance to advocate for them.
BeneLynk’s advocacy and ability to deliver meaningful assistance to members are made stronger through leaders like Vicki Jessup. To learn more about how we partner with health plans to improve member outcomes, contact us today at sales@benelynk.com.