To provide case management services to patients with identified needs related to psychosocial needs and medical services. Have the ability to work in collaboration with medical teams on cases. Serve as an advocate and liaison for and on behalf of patients’ rights and benefits associated with Compass/Medicaid applications, Affordable Care Act, prescription assistance applications, and additional medical plans or psychosocial resources as well. Spanish speaking preferred.
Responsibilities and Duties
- To provide eligibility and enrollment assistance for the Medicaid, Children’s Health Insurance Program (CHIP), and Federal Marketplace health insurance programs to uninsured patients of the health center.
- Will be required to complete up to 30 hours of federal training to obtain consumer assistance certification and will be required to recertify on an annual basis.
- Participate in ongoing training of medical insurance trainings for updates and certifications as needed.
- Provide application and renewal assistance and facilitate enrollment in a health insurance program by providing fair, impartial, and accurate information.
- 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).
- Provides in home help with the Medical Assistance, prescription assistance applications and the attainment of other types of assistance as it arises.
- Assist in the identification and acquisition of all needed forms of personal identification.
- 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.
- Assist with partner hospitals’ financial application process.
- Works with patients in identifying psychosocial needs/barriers to care and then assists them in resolving those psychosocial needs/barriers including referral to Licensed Clinical Social Worker as needed.
- Assist with the development of marketing and promotional materials for outreach, application assistance, and education activities.
- Provide culturally and linguistically appropriate services and ensure physical and other accessibility for people with disabilities.
- Provide information and assistance in the applicants preferred language and or provide limited-English proficiency applicants with oral and written notices of their rights to receive language assistance services and how to obtain such services.
- Provide referrals for people 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.
- Ensure the protection and security of personal, confidential and identifiable information in a professional and responsible manner and carry out all measures to prevent unauthorized disclosures.
- Demonstrate and maintain the standards and requirements of the Health Insurance Portability and Accountability Act (HIPAA).
- Participate in monthly conference calls and/or supplemental in-person trainings and workshops sponsored by Texas Association of Community Health Centers (TACHC) and provide updates to discuss issues, best practices, and modifications or challenges with the online application systems for Medicaid, CHIP, and/or the Federal Marketplace.
- Maintains all appropriate databases and documentation on site and/or in electronic databases as instructed.
- Participate in community meetings related to medical and psychosocial needs of the health center.
- Other duties as assigned.
Qualifications and Skills
- Must have at least two year’s experience in Public Health, Outreach, Social Work or related field.
- Working knowledge of the Pennsylvania Medical Assistant Program, CHIP, and the COMPASS benefit application is preferred.
- Degree in Social Work, Public Health, Public Administration, or similar field from an accredited college or university preferred.
- Strong oral and written communication skills.
- Ability to work effectively and professionally in a fast-paced environment.
- Knowledge of and ability to work and engage with the uninsured, under-served and under-represented populations.
- Must have strong computer skills.
- Spanish and English bilingual preferred
NHCLV offers an excellent benefit package including 8 paid holidays, PTO, a competitive pay rate and an excellent benefit package including medical, dental and vision along with company paid Life and a Short Term Disability plan when eligible!
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The Mission of the NHCLV is to provide primary and preventive health and wellness services in the Lehigh Valley, regardless of a person’s ability to pay. We strive to do this directly and in partnership with other organizations, with a goal of creating a primary health care home for an underserved community.
This is not intended to be a full job description.