Eligibility Outreach Worker

NADR; Hawaii; On-site; USD 40,000 - 56,000; Full time

Job summary

Kalihi-Palama Health Center in Hawaii seeks a program assistant to help uninsured and underinsured clients determine eligibility for Quest, TANF, Medicaid, and other DHHS or federal programs, guiding them through enrollment and ensuring timely processing.

The role includes case finding, referrals, and language-access accommodations, with outreach beyond standard hours to reach disadvantaged populations and reduce barriers to care.

Qualifications

• High School Diploma or GED required; bachelor’s degree preferred.
• Experience with community resources on Oahu is plus; knowledge of eligibility guidelines preferred.
• Ability to communicate clearly in writing and verbally; strong cultural competency.

Responsibilities

• Assist clients in determining eligibility for Quest, TANF, Medicaid, CHIP, and other DHHS/federal programs.
• Provide enrollment assistance and follow-up for Medicare-related programs and renewals.
• Screen and refer clients to community social services based on Social Determinants of Health (SDOH).
• Refer to providers offering sliding fee scales or free care for low-income clients not eligible for public insurance.
• Participate in HPCA trainings and ensure timely reporting of outcomes and activities.
• Provide outreach outside traditional hours and serve diverse populations including pregnant women, children, families, and seniors.
• Ensure services are linguistically and culturally appropriate; accommodate non-English speakers and hearing-impaired clients.
• Comply with local, state, and federal laws; maintain regular on-site attendance.

Skills

Clear communication

Cultural competency

Health insurance knowledge

Eligibility rules knowledge

Computer literacy

Education

High School Diploma or GED

Bachelor’s degree preferred

Job description

Job Description

Job Description

Primary Purpose:

Assist uninsured and/or underinsured clients in determining eligibility for Quest, Temporary Assistance for Needy Families (TANF) and other Department of Health & Human Services (DHHS) or federal programs; facilitate the enrollment process to ensure that all eligible clients are given the opportunity to apply and all applications are monitored in a timely manner.

Essential Duties:

• Provide accurate information, competent enrollment assistance, and follow-up assistance for each of the following medical insurance programs
  • Federal Market Place
  • TANF (Temporary Assistance to Needy Families)
  • Subsidized Housing
  • Food Stamps
  • Medicaid and QUEST (including the State's Children's Health Insurance Program (CHIPS))
  • QMB/SLMB (assistance to the elderly who are qualified for Medicare supplemental programs)
  • Renewal applications for any and all of the above programs as required.
• Provide accurate information, competent enrollment assistance, and follow-up assistance for each of the following financial assistance programs
  • General Assistance (GA) with the Department of Human Services (DHS)
  • Social Security Income (SSI) / Social Security Disability Income (SSDI) with Social Security Administration (SSA)
• Screen and Refer client to appropriate community social services programs based on identified Social Determinants of Health (SDOH) screening
• Refer client to appropriate providers and additional services, where necessary, including referral to health care providers that offers sliding fee scale discounts or free care to low income clients not qualified for public health insurance or assistance.
• Participate in any Hawaii Primary Care Association (HPCA)- sponsored training and update event related to this program.
• Ensure timely reporting that includes
  • Number and types of application completed
  • Number and types of renewal forms completed
  • Demographic stratification of individuals served including client ethnicity, gender, age, poverty level, language assistance rendered, if any, and, for immigrants, country of origin
  • Outcomes of application and renewal determinations
  • Types of outreach activities engaged in and actual or estimated number of people reached
  • Other referrals and/or enabling services provided
  • Notes on other accomplishments or problems encountered
• Make outreach and enrollment services available during non-traditional hours ie: available outside the hours of 8:00am to 4:30pm., Monday through Friday, as appropriate for the population served.
• Serve pregnant women, children, families, immigrants/migrants, people who are homeless, the elderly, and any appropriate special populations.
• Ensure that outreach and enrollment services are linguistically and culturally appropriate. Clients who do not speak English as a native language or who have hearing impairments must appropriately be accommodated.
• Cooperate with referrals from 211/Ask Aloha United Way within the Kalihi-Palama Area

• Finds and develops resources to assist patient care.

• Share ideas about program improvement, complaints, questions, or other matters with supervisor and HPCA on a timely basis.
• Assist clients who may not otherwise be clients of Kalihi-Palama Health Center
• Comply with all applicable local, state, and federal laws and regulations.

Regular and reliable on-site attendance is required.

Other Duties:

• Perform other related duties as assigned
• Observe safety and security procedures; determine appropriate actions beyond guidelines; report potentially unsafe conditions; use equipment and materials properly.

Minimum Qualification Requirements:

Education:

• High School Diploma or GED required.
• Post-secondary education or Bachelor's Degree preferred

Experience:

• Knowledge in Community Resources and Services on Oahu
• One year of experience providing direct Community Services to clients required
• Experience in providing eligibility assistance preferred

Skills/Knowledge:

• Ability to communicate clearly- Verbally and Written form
  • Ability to read and understand technical/medical and eligibility instructions furnished in Knowledge of the community especially Kalihi-Palama area
  • Ability to demonstrate cultural competency with multi-ethnic population - written or oral or diagram, form as needed to carry out this task.
  • Knowledge of health insurance and/or related subject
  • Knowledge on current protocols and/or rules and regulations pertaining to eligibility and immigration
  • Professionalism, sound judgment and emotional stability
  • Proficient in computer technology including word processing, spreadsheets and internet for email and web-based application

Kalihi-Palama Health Center is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.