Health Coverage Counselor

Job Description

Job Description

At Community Medical Centers (CMC), we're passionate about improving health and well-being in the communities we call home. That's why we work to ensure even our most vulnerable neighbors have affordable access to quality healthcare, regardless of age, income, or background. We offer integrated medical, dental, behavioral health, and supportive services, with a model of care that puts the patient at the center of a team-based approach. As one of the region's largest healthcare providers, our growing network of neighborhood health centers serves over 100,000 patients in San Joaquin and Solano counties.

MISSION

Working together to improve health and well-being in our communities.

BENEFITS

• Competitive Pay
• Medical, Dental, & Vision benefits options for full-time employees
• Flexible spending account for medical expenses
• Dependent care
• Employee assistance program
• Life Insurance
• Pet Insurance
• Short Term/Long Term Disability Insurances
• 403(b) retirement saving plan with company match
• 10 paid sick days/12 Holidays/Vacations days vary on position
• In Shape Discounted Gym Membership
• Excellent growth and advancement opportunities
• Collaborative and diverse environment

POSITION SUMMARY:

The Health Coverage Counselor will perform enrollment assistance activities that facilitate enrollment of eligible health center patients and service area residents into affordable health insurance coverage through the Health Insurance Marketplaces, Medicaid, Children's Health Insurance Program/Healthy Families, Medicare, and other payors

SPECIFIC DUTIES:

• Promotes the mission, vision, and values of the organization.
• Consults with and advises the Membership Services Director regularly regarding insurance enrollment activities.
• Responsible for scheduling and conducting educational presentations to groups or individuals in the community on health insurance options and utilization of benefits.
• Assist in all parts of the insurance enrollment process such as educating consumers about affordable coverage options, setting up a profile in the Covered CA Portal, filing affordability assistance information, receiving an eligibility determination, and/or enrolling in affordable health insurance.
• Maintain expertise in eligibility and enrollment rules and procedures, the range of qualified health plan options and insurance affordability programs, the needs of underserved and vulnerable populations, and privacy and security standards.
• Conduct public education activities to raise awareness about coverage options under Medi-Cal, Medicare, CHIP and the Covered CA Marketplace.
• Assist individuals with understanding and accessing affordable options, provide information and assistance in a fair, accurate and impartial manner, provide information and assistance in a manner that is culturally and linguistically appropriate to diverse communities and accessible to individuals with disabilities.
• Assist individuals in information about available health and social services at Community Medical Centers and the community.
• Provide referral to any applicable office of health insurance consumer assistance or ombudsman established under Section 2793 of the PHS.
• Act to address consumer grievances, complaints, or questions about their health plan, coverage, or a determination.
• Responsible for collecting, tracking and entering enrollment information to prepare enrollment reports.
• As needed translate written material related to enrollment.
• Serves as departmental representative at various meetings when assigned.
• Assists with various health insurance activities as assigned and works as a team member to ensure success of enrollment and advocacy events.
• Attends and participates in staff meetings and training as required by Supervisor.
• May assist Patients Services Center and Population Health as directed.
• Responsible for distribution of materials, forms, and reports
• Performs other tasks as assigned

MINIMUM REQUIREMENTS:

• High School Diploma or GED
• One (1) year experience working in a health care program providing health insurance coverage information or two (2) years working in a healthcare setting
• Experience providing health insurance coverage information is preferred
• Knowledge of geographical area and ethnic communities
• Ability to type 35 words per minute
• Ability to comply and successfully complete all required and applicable federal and state consumer assistance training

KNOWLEDGE, SKILLS, AND ABILITIES:

• Knowledge of health insurance programs
• Knowledge of community resources and referral agencies
• Knowledge of computer systems and applications
• Knowledge of grammar, spelling and punctuation to compile and type reports
• Knowledge of instructional skills and educational techniques to guide consumers
• Skill in establishing and maintaining effective working relationships with consumers, staff, and various agencies
• Skill in public speaking
• Ability to identify problems, provide information, and recommend solutions
• Ability to prepare routine reports using terminology common to employees
• Ability to Interpret, adapt, and apply appropriate written guidelines and work practices
• Listens skillfully and displays a willingness and ability to acknowledge the needs, expectations, and values of others by using reflective listening and empathy conveyance. Responds to needs in ways that are helpful and beyond expectation.
• Communicate effectively by using welcoming words, proper tone of voice, appropriate body language, eye contact and smiling with every interaction.
• Ability to provide excellent customer service that is reflective of a culture that values trust and respect.

TYPICAL PHYSICAL DEMANDS:

May require sitting for long periods of time. Occasional bending, stretching or lifting. Requires frequent walking and standing for prolonged periods of time. Lifts and carries items weighing in excess of 50 pounds. Vision must be correctable to 20/40 and hearing must be in the normal range for telephone contacts. Requires the ability to work under demanding conditions. Requires ability to drive to identified areas for presentations and other activities. May require working week nights and weekends.

TYPICAL WORKING CONDITIONS:

Work is performed in an office environment within a clinic setting. Involves frequent contact with staff and the public. Work may be stressful at times. Contact may involve dealing with upset people.

This job description is not intended to be a complete list of all responsibilities, skills, or duties required for the job and is subject to review and change at any time, with or without notice, in accordance with the needs of Community Medical Centers. Since no job description can detail all the duties and responsibilities that may be required from time to time in the performance of a job, duties, and responsibilities that may be inherent in a job, reasonably required for its performance, or required due to the changing nature of the job shall also be considered part of the jobholder's responsibility.

Community Medical Centers is an Equal Opportunity Employer. It is CMC's policy to provide equal employment opportunities to all persons, regardless of age, national origin, race (including hair texture and hairstyle), color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, disability, genetic information (including family medical history), political affiliation, military service, or other non-merit based factors.

At Community Medical Centers (CMC), we’re passionate about improving health and well-being in the communities we call home. That’s why we work to ensure even our most vulnerable neighbors have affordable access to quality healthcare, regardless of age, income, or background. We offer integrated medical, dental, behavioral health, and supportive services, with a model of care that puts the patient at the center of a team-based approach. As one of the region’s largest healthcare providers, our growing network of neighborhood health centers serves over 100,000 patients in San Joaquin and Solano counties.

MISSION

Working together to improve health and well-being in our communities.

BENEFITS

Competitive Pay
Medical, Dental, & Vision benefits options for full-time employees
Flexible spending account for medical expenses
Dependent care
Employee assistance program
Life Insurance
Pet Insurance
Short Term/Long Term Disability Insurances
403(b) retirement saving plan with company match
10 paid sick days/12 Holidays/Vacations days vary on position
In Shape Discounted Gym Membership
Excellent growth and advancement opportunities
Collaborative and diverse environment

Company Description

At Community Medical Centers (CMC), we’re passionate about improving health and well-being in the communities we call home. That’s why we work to ensure even our most vulnerable neighbors have affordable access to quality healthcare, regardless of age, income, or background. We offer integrated medical, dental, behavioral health, and supportive services, with a model of care that puts the patient at the center of a team-based approach. As one of the region’s largest healthcare providers, our growing network of neighborhood health centers serves over 100,000 patients in San Joaquin and Solano counties.\n\nMISSION\n\nWorking together to improve health and well-being in our communities.\n\nBENEFITS\n\nCompetitive Pay\nMedical, Dental, & Vision benefits options for full-time employees\nFlexible spending account for medical expenses\nDependent care\nEmployee assistance program\nLife Insurance\nPet Insurance\nShort Term/Long Term Disability Insurances\n403(b) retirement saving plan with company match\n10 paid sick days/12 Holidays/Vacations days vary on position\nIn Shape Discounted Gym Membership\nExcellent growth and advancement opportunities\nCollaborative and diverse environment