Community Enrollment Specialist

If interested, please apply and sent your resume to [email protected]

POSITION SUMMARY

Reporting to the Supervisor, Social and Community Relations, the Community Enrollment Specialist will assists patients / clients, either directly or indirectly through referral, enroll into the appropriate coverage program;

enrollment / re-enrollment in Medi-Cal, Covered California, Healthy Families, Cal-Fresh and others. Assist with the application enrollment process and provide follow-up to ensure enrollment, utilization, and retention for MLKCH.

In addition, process of accessing Public Benefits; develop relationships with community agencies to keep steady flow of new patients into MLKCH.

Will educate potential patients about health coverage programs and various private and government-sponsored programs including Medi-Cal, Covered California, Cal-Fresh, and others.

Will conduct brief health education / awareness and outreach contacts and encounters. Coordinates enrollment and outreach efforts for businesses with MLKCH growth and reputation initiatives efforts and implements a comprehensive outreach strategy within the community.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Screen for eligibility and provide assistants to patients / clients enrolling into Medi-Cal, Covered California and developing a systematic referral network plan and execution to assist with MLKCH growth.
• Assist established and potential patients with establishing care at MLKCH as their primary care home and booking appointment.
• The Community Enrollment Specialist will be accountable for monitoring, analyzing, and reporting activity against established monthly goal.
• Run eligibility status for patients / clients through Next Bar Experian and ensure enrollment is assigned correctly under appropriate PCP / Clinic / Medical Group.
• Maintain and update all patient / client records in regards to benefits via Revenue Cycle and / or EHR system.
• Review status and follow up to confirm enrollment, encourage the utilization of health insurance benefits and services.
• Will provide education and health enrollment assistance to potential patients in the community about healthcare options, including Medi-Cal, Covered California, Healthy Familie, Cal-Fresh and others.
• Assist those experiencing difficulties (e.g., enrollment troubleshooting and advocacy on behalf of the family, barriers to enrollment, utilization and retention) and offer retention assistance.
• Identify outreach locations in the community to provide health coverage and other government-sponsored programs.
• Drives enrollment results through the implementation of the outreach and enrollment plan for the designated area.
• Make sure that prenatal patients and their newborns are enrolled in Medi-Cal, Covered California, and / or other health care options available.
• Works with the Supervisor of Social and Community Relations to develop target outcomes for enrollment, outreach initiative, and maintain an extensive awareness of community-based patient resources.
• Adhere to all policies as set forth by Medi-Cal and Covered California and government-sponsored programs.
• Prepares monthly community enrollment and outreach report, documenting contacts generated, follow up activities and estimates of resources needed for next strategic steps.
• Attend / Conduct any community health fairs and other places where people congregate for enrollment assistance and MLKCH growth (including selected weekday and weekend events when assigned).
• Assists MLKCH growth and reputation initiatives efforts targeting potential patients and eligible community members, including participating in presentations and open enrollment activities.
• Will have a quota of 20 a month that will be compensated and quota is subject to change based on season.
• Other duties as assigned

POSITION REQUIREMENT

A. Education

• High school diploma or GED required. Associate’s Degree, Bachelor’s Degree, in Healthcare, Business Administration or related field preferred.
• Certified Application Assister (CAA)
• Certified Enrollment Counselor (CEC) certification preferred

B. Qualifications / Experience

• Bilingual English / Spanish required
• Two (2) or more years of experience working with Medi-Cal, Covered California, health insurance programs and other public benefits.
• Experience working with individuals from diverse ethnic, educational, cultural and socioeconomic backgrounds, gender identity, sexual orientation.
• Interest in advocating promoting health care accessibility.
• Exceptional interpersonal skills and team player.
• Follow agency policies and maintain organizational standards with regards to patient / client confidentiality and HIPAA compliance.
• Current valid California Driver License and Insurance Certificate.

C. Special Skills / Knowledge

• Proficiency in Windows computer software, web-based portal systems, and internet web browsers.
• Strong verbal and written communication skills and active listening skills.
20 days ago