Health Coverage Counselor

Community Medical Centers Inc; Dixon (CA); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

403(b) retirement plan with company 
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Paid time off

Gym membership/Wellness program

Job summary

Community Medical Centers is seeking a Health Coverage Counselor to help patients enroll in health coverage via the Marketplace, Medi-Cal, CHIP, Medicare, and other payors. You will educate the community about affordable options, assist with portal setup and eligibility determinations, and maintain enrollment records.

The role emphasizes culturally competent communication and collaborative outreach efforts.

Qualifications

• Knowledge of health insurance programs and eligibility rules.
• Ability to translate complex options into understandable terms.
• Experience communicating with diverse communities and stakeholders.
• Attention to accuracy in enrollment data and records.

Responsibilities

• Promotes the mission and goals of Community Medical Centers.
• Educates and assists individuals with enrollment in health insurance programs.
• Filing affordability assistance information and entering enrollment data.
• Present information in a culturally and linguistically appropriate manner.
• Serve as a liaison for health insurance resources and referrals.
• Attend meetings and support enrollment and advocacy events.

Skills

Knowledge of health insurance programs

Public speaking

Customer service

Communication skills

Empathy and cultural sensitivity

Education

High School Diploma or GED

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.MISSIONWorking together to improve health and well-being in our communities.BENEFITSCompetitive PayMedical, Dental, & Vision benefits options for full-time employeesFlexible spending account for medical expensesDependent careEmployee assistance programLife InsurancePet InsuranceShort Term/Long Term Disability Insurances403(b) retirement saving plan with company match10 paid sick days/12 Holidays/Vacations days vary on positionIn Shape Discounted Gym MembershipExcellent growth and advancement opportunitiesCollaborative and diverse environmentPOSITION 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 payorsSPECIFIC 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 reportsPerforms other tasks as assignedMINIMUM REQUIREMENTS:High School Diploma or GEDOne (1) year experience working in a health care program providing health insurance coverage information or two (2) years working in a healthcare settingExperience providing health insurance coverage information is preferredKnowledge of geographical area and ethnic communitiesAbility to type 35 words per minuteAbility to comply and successfully complete all required and applicable federal and state consumer assistance trainingKNOWLEDGE, SKILLS, AND ABILITIES:Knowledge of health insurance programsKnowledge of community resources and referral agenciesKnowledge of computer systems and applicationsKnowledge of grammar, spelling and punctuation to compile and type reportsKnowledge of instructional skills and educational techniques to guide consumersSkill in establishing and maintaining effective working relationships with consumers, staff, and various agenciesSkill in public speakingAbility to identify problems, provide information, and recommend solutionsAbility to prepare routine reports using terminology common to employeesAbility to Interpret, adapt, and apply appropriate written guidelines and work practicesListens 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.