To facilitate consumer enrollment in a Qualified Health Plan (QHP) through the Federal Marketplace and or other health programs such as Medicaid, Pre-Existing Condition Insurance Program (PCIP) and Children’s Health Insurance Program (CHIP) by providing fair, impartial, and accurate information that assists consumers with submitting the eligibility applications, clarifying distinctions among QHP’s, and helping qualified individuals make informed decisions during the health plan selection. The Outreach/Enrollment Specialist will conduct consumer assistance activities as well as outreach and education activities to consumers and businesses about the availability of these programs and insurance affordability to encourage participation. The Outreach/Enrollment Specialist will provide all services for the public good and serve as a resource to all consumers, including but not limited to, existing patients of the health center as well as to consumers, particularly from communities that are underserved by and under-represented in the current health insurance market.
B. PRIMARY RESPONSIBILITIES:
1. Provide application assistance and facilitate enrollment of eligible patients and community members in health insurance programs.
2. Maintain knowledge and expertise in eligibility, enrollment, and program specifications of the Federal Marketplace and other health coverage programs such as Medicaid and CHIP.
3. Implement outreach strategies to promote the availability of health insurance and encourage participation of consumers particularly in communities that are underserved and underrepresented in the current health insurance market.
4. Conduct outreach and education activities to educate health center patients, consumers, businesses, community organizations and other stakeholders about insurance affordability through the Marketplace, Medicaid and/or CHIP to encourage participation.
5. Provide information and assistance in the consumer’s preferred language and or provide limited-English proficiency consumers with oral and written notices of their rights to receive language assistance services and how to obtain such services.
6. Provide referrals for consumers with questions, complaints, or grievances to any applicable office of health insurance consumer assistance or health insurance ombudsman, or any other appropriate state agency or agencies.
7. Ensure the protection and security of a consumer’s personal, confidential and identifiable information in a professional and responsible manner and carry out all measures to prevent from unauthorized disclosures.
8. Demonstrate and maintain the standards and requirements of the Health Insurance Portability and Accountability Act (HIPAA).
9. Participate in monthly conference calls and regularly scheduled meetings with the
Outreach/Enrollment Specialist Project Management team at LPCA and provide updates to discuss issues, best practices, and modifications or challenges with the federal application and/or online application for Medicaid and CHIP, and/or the Federal Marketplace.
10. Build new relationships and maintain existing ones with current and future community entities that are providing services to consumers to promote health insurance coverage through the Federal Marketplace, Medicaid, and or CHIP.
11. Participate in CMS, DHH and other required training for Outreach/Enrollment Specialist certification and to enhance outreach and enrollment expertise.
12. Provide data and other information necessary for LPCA and other reporting requirements.
13. Assist with the development and dissemination of marketing and promotional materials for outreach, application assistance and education activities that are tailored to the health center service delivery area and target population.
14. Provide application and renewal assistance and facilitate enrollment in a health insurance program by providing fair, impartial, and accurate information.
15. Maintain knowledge and expertise in eligibility, enrollment, and program specifications of the Medicaid and CHIP programs and have some basic knowledge of the Qualified Health Plans (QHP).
16. Conduct monthly in-reach, outreach and education activities to existing health center patients and community residents to promote awareness about coverage options under Medicaid, CHIP, and the Marketplace.
17. Assist with the development of marketing and promotional materials for outreach, application assistance and education activities.
18. Provide culturally and linguistically appropriate services and ensure physical and other accessibility for people with disabilities.
19. Must be emotionally mature and able to function effectively under stress and the ability to organize and prioritize work.
20. Perform other duties as assigned by supervisor.
1. Bachelor’s degree preferred. Preferably in Social Work, Public Health, Public Administration, Marketing or similar field from an accredited college or university preferred. Five relevant years of experience can be substituted for bachelor’s degree.
2. Medicaid Application Certification or the ability to attain within timeframe deemed by issuing agency.
3. Strong team-based, results oriented, analytical and problem-solving skills s must.
4. Knowledge of healthcare laws, regulations, and standards.
5. Strong oral presentation and written communication skills.
6. Ability to work effectively and professionally in a fast-paced environment.
7. Computer literate in Microsoft, Excel and PowerPoint Presentation programs.
8. Ability to work independently and think critically.
9. Knowledge of and ability to work and engage with the uninsured, underserved and underrepresented populations.
10. Spanish and English bilingual a plus.
11. Must have excellent written and oral communication skills.
12. Able to organize, prioritize and work independently as well as schedule and produce work in a timely manner.
13. Required to travel amongst all CareSouth sites.
1. Visual acuity – always; computer application.
2. Hand – eye coordination – always.
3. Work is a combination of sedentary and steady movement based on project/event.
4. Lifting approximately 10-15 lbs, Pushing, Pulling – sometimes.
5. Stooping, Bending – as needed; sometimes.
6. Sitting, Standing – frequently.
7. Walking- frequent; short distances.
8. Must be capable of standing on a step stool and reaching above head and shoulder area.
F. WORK ENVIRONMENT:
1. Indoor and outdoor elements.
2. Exposure to disease or infections.
3. Exposure to artificial and/or natural light.
Please submit a completed employment application found at www.caresouth.org/jobs or the HR office, resume, and credentials via email to firstname.lastname@example.org or deliver to the HR office. CSMD is an EOE.
CLOSING: This announcement will remain open until filled.