Benefits Case Manager

Center for Elders' Independence; Oakland (CA); On-site; USD 36,000 - 54,000; Full time

Job summary

Center for Elders’ Independence is seeking a Benefits Case Manager to ensure CEI participants are enrolled in all eligible income and insurance benefits. You will collaborate with participants, families, payees and government agencies to address eligibility issues while supporting benefit-related projects across the agency.

The role involves managing caseloads, attending enrollment meetings, conducting home visits, and maintaining accurate documentation in the CEI database.

Qualifications

• Experience or knowledge in benefits such as Medi-Cal, Medicare and other common seniors benefits.
• Excellent customer service and service recovery skills.
• Strong case management skills and ability to work with cross-functional teams.

Responsibilities

• Manage participant benefits eligibility and address issues with participants, families, payees and agencies.
• Oversee assigned caseload, attend enrollment and care conference meetings, conduct home visits.
• Maintain organized CEI database and generate regular eligibility reports.

Skills

Benefit knowledge (e.g., Medi-Cal,MedA

Customer service

Case management

Communication skills

Bilingual (English/Spanish)

Tools

Salesforce

Spreadsheets

Word processing

Job description

The Center for Elders’ Independence (CEI) provides a Program of All-Inclusive Care for the Elderly (P.A.C.E.) - a comprehensive healthcare model specifically designed for low-income, frail seniors. It combines medical and social services along with vigilant care planning and coordination in order to keep frail seniors safely living at home and in their communities. This unique and highly effective model utilizes an interdisciplinary team approach to care planning to drive high quality, affordable, integrated healthcare services to the elderly.

Position : Under the supervision of Director of Enrollment and Member Services, the Benefits Case Manager ensures that all CEI participants are enrolled in all income and insurance benefits that they are eligible for. Benefits Case Manager will be required to work effectively with participants, participant families, representative payees and relevant government agencies to proactively maintain and address benefit eligibility issues that arise as well as support different prospect/participant benefit related projects within the agency.

The hourly pay range for the Benefits Case Manager position at Center for Elders’ Independence is $2 6.25 to $ 39.38 . Placement within the range is determined based on job-related factors such as relevant experience, skills, abilities, internal equity, and market data, consistent with CEI’s annual compensation review and established compensation practices.

Essential Job Functions:

Department and Caseload Management

• Benefits Case Manager keeps track and ensures that all participants’ benefits eligibility needs are met; this includes working directly with the participants, participant families, representative payees and the relevant government agencies to proactively maintain benefit eligibility and resolve all eligibility issues that arise.
• Manages the assigned participant eligibility caseload which includes attending enrollment, care conference meetings and conducting home visits with participants where eligibility issues need to be addressed.
• Manages the caseload information on participants in a well-organized and secure filing system as devised by the department.
• Keeps track and monitors the eligibility status of the participant assigned to the caseload and generates regular reports as needed.
• Ensures that the CEI participants’ income information assigned to the caseload is known and verified at all times and is well documented in the CEI database.
• Ensures that accurate share-of-cost information is gathered, well documented and communicated with the participant on the caseload and the finance staff in an effective and in a timely fashion to enable CEI to collect share-of-cost revenue.
• Works with the participants, families and social workers connected to the assigned caseload to ensure that the Board and Care and SNF income level changes are made by the social security administration, that all involved understand the changes and that the benefit levels are accurate on all Board and Care documents.
• Communicates income issues to social work, finance, member services and other pertinent staff as needed affiliated with the participant on the caseload to ensure interdepartmental effectiveness.

Insurance Benefits

• Ensures that all CEI participants’ benefit information on the assigned caseload is known and verified at all times and well documented in the CEI database.
• Ensures that CEI participants who are assigned to the caseload are fully enrolled in Medi-Cal and any Medicare benefits they are eligible for prior to enrollment and following enrollment ( ie assist with getting participants who are Medi-Cal only qualify for Medicare and participant missing Medicare Part A qualified for QMB benefit to obtain Part A coverage).
• Manages Medi-Cal re-certification to ensure that eligibility is maintained for all participants and facilitate proper communication and documents if retro payment request needs to be processed for month reflecting no payment code.
• Verify IHSS enrollment information prior to enrollment and document in CEI database for proper termination after enrollment.
• Communicates insurance issues to social worker , finance , member services and other pertinent staff as needed affiliated with the participant on the caseload to sure interdepartmental effectiveness.

Relevant Skills and Experience:

• Experience or knowledge in benefit such as Medi-Cal, Medicare and other common benefits available for seniors.
• Excellent customer service and service recovery skills.
• Strong case management skills. Ability to work closely with cross-functional team members including Outreach and Enrollment staff and IDT staff at the PACE centers.
• A demonstrated history of success in goal attainment.
• Excellent communication and presentation skills, both oral and written.
• Must be proficient with computer applications including spreadsheets, word processing and Customer Relationship Management (Salesforce).
• Excellent decision-making ability, customer service and negotiation.
• Possess the capacity to work in a high-stressed, high paced environment while maintaining a positive attitude.
• Self-motivated and able to work independently with minimal supervision.
• Bilingual preferred: English/Spanish; English / Cantonese or Mandarin Chinese; English / Vietnamese or other.
• A passion for working with the senior and underserved populations.

Physical and Travel Requirements:

• Ability to sit, stand, stoop, reach, lift (up to 40 pounds), bend, etc.; hand and wrist dexterity to utilize keyboard.
• Travel within assigned territory and agency sites and programs.
• Valid driver's license, reliable transportation and insurance coverage required.

The above job description is intended to communicate the general function of the mentioned position and by no means shall be considered an exhaustive or complete outline of the specific tasks and functions that will be required. CEI reserves the right to change job descriptions, site assignments, and or work hours as required by the needs of the program. All employees are expected to perform their duties within their ability as required by the job and/or as requested by management.

Placement within the compensation range listed here is determined by job-related qualifications, experience, internal equity, and market factors, consistent with CEI compensation practices.

Salary Range

$26.25 - $39.38 USD

U.S. Standard Demographic Questions

We invite applicants to share their demographic background. If you choose to complete this survey, your responses may be used to identify areas of improvement in our hiring process.

Voluntary Self-Identification

For government reporting purposes, we ask candidates to respond to the below self-identification survey.Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiringprocess or thereafter. Any information that you do provide will be recorded and maintained in aconfidential file.

As set forth in Center for Elders' Independence’s Equal Employment Opportunity policy,we do not discriminate on the basis of any protected group status under any applicable law.

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection.As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measurethe effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categoriesis as follows:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.