Insurance Coordinator

Insurance Coordinator

The Insurance Coordinator provides a range of intensive, client-centered services to persons with HIV/AIDS. The primary role of the Insurance Coordinator is to ensure access to pay sources for health care through public benefits, private insurance, Marketplace Plans or other sources. This includes education, advocacy and assistance to clients and education of Social Services staff on insurance and benefit plan eligibility, changes and enrollment procedures. Other key roles include retention in health care and addressing medical, psychosocial, and other issues that present barriers to care through referrals to case management and to other needed services.

Winning skills and behaviors for success include:

• Coordinate efforts to identify uninsured, and insurable, patients and clients statewide with the intent to connect them to a pay source for care, with the primary goal of adherence to HIV and primary medical care. Gather information on the uninsured through Provide Enterprise, EPIC and QS1. Working with the Director, assign appropriate case management staff to follow up with the uninsured, including assignment to the Insurance Coordinator for area clients and patients without a Case Manager. Devote efforts during open enrollment periods for the Marketplace Insurance plans to reach clients and patients not only believed to be uninsured and eligible of Marketplace coverage, but also those who could benefit from a change in Marketplace plans.
• Lead access to the Affordable Care Act (ACA) in the agency by directing the process annually, developing and maintaining policies and procedures, identifying strategies for enrollment, and ensuring statewide involvement. The Insurance Coordinator will maintain a strong working knowledge of the ACA through training for Certified Application Counselors (CACs), attendance at relevant conferences and workshops, online reading, list-serves, and other available resources.
• Educate case management and housing staff statewide on benefit and insurance issues. Provide "benefits and insurance 101" training to newly hired case management staff. Provide ongoing educational workshops to statewide case management staff to ensure they are current on changes and updates in benefit and insurance programs. Act as a resource for staff navigating complex benefit and insurance issues with clients.
• Directly assist uninsured patients with enrollment in medical care pay sources according to their income, residency and other eligibility factors, including programs available through the state (Medicaid, SSI, SSDI) and the Insurance Marketplace. Educate clients and patients on insurance plan options that are in-network at key healthcare systems where they obtain care. Assist clients and patients statewide with obtaining pay sources for care through client and patient workshops on benefits and insurance, offering appointment days for enrollment on-site at the four Medical Centers and two Pharmacies, and helping with mailings to clients about these issues.
• Educate and enroll eligible patients in the Vivent Health HIV Medical Home during provision of insurance and benefit enrollment activities. Ensure that that EPIC touches are accomplished for enrollment patients accessing assistance from the Insurance Coordinator. Work with the Clinic Case Managers to optimize access to care by persons with HIV infection and to provide necessary education, support, referral and guidance so that patients can more readily improve their health status.
• Help monitor insurance and benefit policy and government level changes to ensure that Vivent Health is on the forefront of insurance issues impacting client and patients. Collaborate with VP of Government and Public Relations by communicating about policy changes that could have an effect on clients and patients and assist with macro level advocacy, as applicable.
• Contribute as an active member of the Social Services department by participating in staff meetings, team meetings, client staffing meetings (when appropriate), in-service and training events; department planning activities, assisting in special projects, and providing support or peer mentoring as appropriate.
• Inform clients of the services available through Vivent Health and in the community and refer and link clients to them as appropriate. When needed, provide support to Case Management functions by assisting with provision of support services such as support groups, food pantry, housing assistance, school supplies, holiday gifts, volunteer services, transportation assistance, and financial assistance.
• Maintain appropriate client files and timely documentation of services utilizing electronic case management and/or medical software such as Provide Enterprise and EPIC.
• Through ongoing training, reach and maintain a strong working knowledge of HIV/AIDS, treatment options, risk reduction techniques, chronic diseases, mental health issues, case management, insurance and benefit programs, and other related issues to better aid clients and patients.
• This job description is not all-inclusive and outlines the main responsibilities and requirements of the role. Employees may be asked to perform additional job-related tasks as needed.
• Adherence to all agency policies, including Confidentiality, Employee Handbook, Health Care Corporate Compliance Plan, Standards of Conduct, and other relevant policies.

Required and preferred knowledge and experiences to succeed include:

• High school diploma or GED.
• Working knowledge of Spanish language (bilingual) is required.
• Minimum of two years' experience offering direct client contact in a community based social service or health service agency.
• Willingness to travel within the designated territory and willingness to work evenings and weekends as needed.
• Valid Driver License, insurable driving record and access to a reliable insured vehicle
• Knowledge of government benefit programs, private insurance, and Marketplace insurance
• Knowledge of and sensitivity to the HIV/AIDS patient population, and/or an eagerness to learn about this community.
• Knowledge of medical, social and mental health delivery systems.
• Demonstrated effective written and verbal communication skills, including assessment skills and providing effective presentations.
• Ability to maintain effective organization of work and keep clear records.

Additional Preferred Qualifications:

• HIV experience in a not-for-profit environment.

Vivent Health is an equal opportunity employer and will recruit, hire, promote, and transfer qualified persons into all job classifications regardless of race, gender, religion, skin color, national origin or ancestry, physical disability (including pregnancy), mental disability, age, gender identity, sexual orientation, legally protected medical condition, family care status, marital status, veteran status, genetic characteristics, or any other characteristic protected by federal or state law. Vivent Health complies with other expanded protected classifications that specific county or municipal regulations may mandate.

Vivent Health is deeply committed to fostering respect, dignity, and understanding for all individuals affected by HIV, regardless of race, ethnicity, sexual orientation, gender identity, socioeconomic status, or any other characteristic. We are dedicated to cultivating a supportive and inclusive environment that champions advocacy, education, and compassionate care for everyone in our diverse community.

Going beyond the law's requirements, Vivent Health places great importance on fostering a culture that celebrates diversity, equity, inclusion, and belonging. We actively seek qualified candidates from different racial, cultural, and economic backgrounds, as we believe that differing perspectives and experiences make us stronger as an organization. Vivent Health encourages all interested persons to apply for this position, and we look forward to learning more about your unique background and qualifications.

As a recipient of federal funding, Vivent Health will not hire nor enter a contractual relationship with any party debarred, suspended, or excluded from federal assistance programs.

Pay Rate Range: $24.00/hourly - $26.00/hourly (Depending on Experience)

The final salary will be determined based on factors such as market data, internal equity, candidate experience and qualifications. Please note that it is uncommon for an individual to be hired at or near the top of the range.

Why join us?

• Generous PTO, including 12 paid holidays
• 401(k) with 100% employer match up to 5%
• 12 weeks fully paid parental leave for benefits-eligible employees after one year
• Employer-subsidized medical, dental, vision, and gender-affirming care
• Tuition reimbursement and licensure assistance
• Benefits for full-time and eligible part-time roles

Public Student Loan Forgiveness

Employment at our organization may qualify you for federal student loan forgiveness programs. We do not directly pay for nor forgive federal student loans; however, our status as a not-for-profit organization under Section 501 (c) (3), makes us an eligible employer. There may be other determining factors for one to qualify.

Please follow this URL to review one such program and their requirements:

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.