PUBLIC BENEFITS & INSURANCE NAVIGATOR

Job Description

Job Description

About Whitman-Walker

Whitman-Walker envisions a society where all persons are seen for who they are, treated with dignity and respect, and afforded equal opportunity to health and wellbeing. Through care, advocacy, research, and education, we empower all persons to live healthily, love openly, and achieve equality and inclusion. For over 50 years, we have been meeting the needs of our communities with the endless dedication of our diverse teams.

Job Summary

The Public Benefits and Insurance Navigator role helps patients and DC, MD, and VA residents with health insurance and public benefits eligibility, enrollment, and literacy - connecting people to Medicaid, Medicare, and Qualified Health Plans on the exchange, subsidies, other insurance opportunities, and public benefits. The person in this role will gain technical content and client counseling and navigation skills. While the PBIN Navigator will be trained and supervised by the Legal Services program, they are part of a specialized Insurance Navigation Team that, since 2007, has worked closely with reception and billing staff as well as medical, behavioral, and dental staff to ensure health insurance coverage for our patients. PBIN Navigator has been on the front lines of implementation of health reform as certified DC Health Link Assisters and providing critical consumer outreach and enrollment assistance to uninsured and under-insured DC, MD, and VA residents.

Core Whitman-Walker Primary Essential Duties:

• Performs and behaves in accordance with Whitman-Walker’s mission, cultural norms, and core values of dignity, respect, affirmation, and humility.
• Maintain a respectful, non-judgmental, and compassionate manner with patients/clients/staff.
• Demonstrate excellent customer service by identifying and exceeding customer requirements.
• Adhere to Whitman-Walker policies and procedures, with special attention given to HIPAA requirements.
• Maintain data integrity through conscientious use of relevant tools and employing a system of checks and balances.
• Demonstrate organizational skills necessary to multi-task, meet deadlines, and re-prioritize as needed.
• Participate in organizational quality and performance improvement activities.

Role Specific Primary Essential Duties:

• Must be a strong team player and able to cultivate good working relationships both internally as part of integrated services and externally with staff at the government offices where applications are filed and for troubleshooting and advocating with those offices.
• Manages assigned cases in Legal Server in which the Navigator has assisted clients in applying or advocating to external partners. Monitor the cases until there is a decision.
• The individual hired for this position will join the Insurance Navigation Team and rotate between all WWH sites.
• Assists consumers/patients by providing critical outreach, education, and counseling for consumers/patients seeking insurance.
• As part of Whitman-Walker’s integrated service model, PBIN Specialists serve an important role to help ensure access to care.
• Screens for insurance options and assists eligible clients in applying for insurance through the DC Health Benefit Exchange or other relevant options.
• Assists with both Qualified Health Plan options as well as public benefit options, including but not limited to Medicaid, Medicare Savings Programs, the DC Healthcare Alliance, SNAP, TANF, HIV/AIDS-specific public benefits (including AIDS Drug Assistance Programs, and AIDS Insurance Assistance Programs), and other public benefits across all Whitman-Walker jurisdictions.
• Participates in yearly Part D open enrollment working with legal services to support our client’s medication needs.
• Explains the different options available through the Exchange or public insurance, the plan’s affordability, cost-sharing structure, and the consumer rights available under these options.
• Assists eligible clients in completing relevant applications, securing necessary supporting documentation, and filing the applications with the appropriate agencies. Documenting and tracking applications and submissions, advocating for consumers with government offices as necessary, and operating as front-line screeners for matters that need referrals to Whitman-Walker attorneys or other health center Senior Specialists for further support.
• Explains the different options available through the Exchange or public insurance, the plan’s affordability, cost-sharing structure, and the consumer rights available under these options
• Assists eligible clients in completing relevant applications, securing necessary supporting documentation, and filing the applications with the appropriate agencies. Documenting and tracking applications and submissions, advocating for consumers with government offices as necessary, and operating as front-line screeners for matters that need referrals to WWH attorneys or other health center Senior Specialists for further support.
• Manages the tracking of clients' applications in Legal Server and advocates as necessary.
• Updates client information and uploads documents into WWH’s electronic medical record system and LS, as needed
• Other duties as assigned.

Core Whitman-Walker Knowledge, Skills, and Talents Required:

• Ability to work independently with minimal supervision.
• Ability to manage time and effort to meet strategic objectives and complete work.
• Knowledge of principles and processes for providing excellent customer service, both internal and external.
• Knowledge of all applicable WWH policies and procedures.
• Excellent oral and written communication skills.
• Knowledge of healthcare information systems with the ability to adapt to new insurance eligibility, electronic medical records, and population health platforms.
• Ability to maintain records and information in an accurate, timely, and confidential manner.
• Ability to adapt to changes in the service delivery model, re-prioritizing as necessary.
• Flexibility to work various shifts, including afternoon and evening shifts as necessary.
• Flexibility to work within the organization's various locations as necessary.
• Commitment to health equity.

Role Specific- Knowledge, Skills, and Talents Required:

• Former certified DC Health Link in-Person Assister or Certified Application Counselor preferred (Position will require completion of CAC certification within first 90 days)
• Successful completion of 4–6-week internal WWH PBIN Training.
• A passion for assisting others and a strong interest in access to care are required.
• The ability to quickly learn and stay on top of updates to insurance options for commercial and public benefits programs, specifically eligibility criteria, benefits, application procedures, and how to troubleshoot problems as they arise.
• The ability to work on multiple tasks simultaneously and triage a high volume of patients and consumers seeking PBIN assistance.
• The ability to recognize cultural, language, and learning differences and be able to assist individuals in an affirming and culturally and linguistically appropriate manner.
• The ability to grasp complex facts, procedures, and laws. The ability to work quickly, independently, and responsibly.
• Must be a collaborative problem solver, effective communicator, and embrace a diverse team environment.
• Strong interpersonal and customer service skills; the ability to work comfortably with clients, volunteers, and staff of diverse backgrounds; and a high level of comfort with HIV/AIDS and with persons of different sexual orientations and gender identities.
• Strong computer skills, including knowledge of Microsoft Office tools and the ability to quickly learn new programs, including electronic medical records and insurance-related web programs.
• Strong organizational, record-keeping, and writing skills, and attention to detail.

Education and Experience Required:

• A bachelor’s degree or 4 to 5 years or more of relevant experience in (healthcare, social services, eligibility and enrollment, customer service/reception in a similar field).
• Experience working with members of the Lesbian, Gay, Bisexual, Transgender, Gender Expansive, Queer, Asexual, and Intersexed communities preferred.
• Experience working with people living with HIV or issues related to HIV care preferred.

The above job description is designed to indicate a general sense of the duties and expectations of this position. It is not to be interpreted as a comprehensive inventory of all duties and responsibilities required. As the nature of our business demands change, so too, may the duties and responsibilities of this position. You may be required to perform other duties as requested, directed, or assigned.

Whitman-Walker is an equal employment opportunity employer and does not discriminate against applicants, its employees, or former employees based on race, color, religion, gender, marital status, sexual orientation, national origin, age, disability, veteran status, or gender identity. For accommodation in the application process, please contact Human Resources.