Plan Based Enrollment Counselors

CCHP Health Plan; San Francisco (CA); Hybrid; USD 33,000 - 34,000; Full time

Job summary

CCHP Health Plan is seeking a Plan Based Enrollment Counselor to educate customers and assist with enrollment into the Covered California program. The role includes guiding clients through eligibility and enrollment processes, and providing referrals to health and social services.

The PBE educates members on how health care is organized, potential services, and transitions to ongoing administration of agreements and annual renewals. Fluency in English and Cantonese/Spanish is desirable.

Qualifications

• Two years customer service or enrollment assistance experience.
• Prior managed care experience.
• Certification as a Certified Application Assistor (CAA) desirable.
• Excellent oral communication, customer service and organizational skills.
• Fluency in English; Cantonese or Spanish desirable.

Responsibilities

• Explain to customers how health care is delivered in the community.
• Prepare for Covered California certification to assist with enrollment activities.
• Provide strong customer service and support to existing and potential clients.
• Receive and handle inquiries by telephone, mail, and in person for enrollment into the Covered California program.
• Pre-screen and assist applicants for program eligibility determination and enrollment.
• Coordinate with other team members as needed to assist customers.
• Provide language assistance to people with limited English proficiency for enrollment and patient navigation.
• Assist with Open Enrollment outreach activities.
• Accepts and performs other duties as assigned.

Skills

Customer service

Enrollment assistance

Managed care experience

Certified Application Assistor

Job description

The Plan Based Enrollment Counselors help enroll new or existing members for renewal into the Covered California Program. The PBE educates customers on how the health care system is organized, what services are available to them, and provides enrollment referrals or assistance to public or private health/social services. The PBE also serves as the Certified Application Assistor. The PBE transitions to ongoing administration of the terms in the agreements with Covered California and facilitates annual renewals.

Essential Duties and Responsibilities

• Ability to understand and explain to customers how health care is delivered in the community
• Prepare for Covered California certification to assist with enrollment activities
• Provides strong customer service and support to existing and potential clients
• Receive and handle inquiries by telephone, mail, and in person assistance for enrollment into the Covered California program
• Pre-screen and assist applicants for program eligibility determination and enrollment
• Coordinate with other team members as needed to assist customers
• Provide language assistance to people with limited English proficiency for enrollment and patient navigation
• Assist with carrying out Open Enrollment outreach activities
• Accepts and performs other duties as assigned

CORE COMPETENCIES

• Must possess and consistently demonstrate the following competencies:

Management - Makes the best use of available time and resources. Acknowledges and corrects mistakes. Shows up to work on time, and follows instructions, policies, and procedures. Meets productivity standards, deadlines, and work schedules. Prioritizes tasks by importance and deadline. Displays an ongoing commitment to learning and self-improvement. Desiring and making an effort to acquire new knowledge or skills for work.

Leadership Effectiveness - Leads by example and sets standards for professional behavior. Helps those in need of assistance, regardless of rank. Offers help when needed. Identifies what needs to be done and takes action before being asked or required. Recognizes situations that warrant initiative and moves forward without hesitation. Displays a positive attitude about the work to be done, co-workers, customers, management, and policies. Conveys positive attitude in the process of change.

Decision Making and Judgment - Coordinates ideas and resources to achieve goals. Identifies, collects, and organizes data for analysis and decision-making. Shows insight into the root-causes of problems. Generates a range of solutions and courses of action with benefits, costs, and risks associated with each. Examines data to grasp issues, draw conclusions, and solve problems.

Teamwork - Conveying confidence in co-workers’ ability to be successful, especially with new and challenging tasks. Earns others’ trust and respect through consistent honesty and professionalism in all interactions. Builds constructive working relationships characterized by a high level of acceptance, cooperation, and mutual respect. Maintains an open, approachable manner, and treats others fairly and respectfully. Preserves others’ self-confidence and dignity, and shows regard for their opinions. Promotes cooperation and commitment within a team to achieve goals and deliverables.

Continuous Improvement - Adapting to and working with a variety of situations, individuals, and groups. Demonstrates openness to new organizational structures, procedures, and technology. Openness to different and new ways of doing things. Willingness to modify one’s way of doing things. Diligently attends to details and pursues quality in accomplishing tasks. Develops fresh ideas that provide solutions to all types of workplace challenges.

Communication - Keeps manager informed about progress and problems. Ensures that others involved in a project or effort are kept informed and developments and plans. Allows others to speak without unnecessarily interrupting them. Gives the speaker undivided attention and appears interested in the message (e.g., maintains eye contact, nods). Gets along and interacts positively with co-workers and others. Asks and answers questions that enhance the clarity, quality, and reliability of information.

Work Product Quality - Adheres to all workplace and trade safety laws, regulations, standards, and practices. Displays openness to different or new ways of doing things and sees multiple perspectives. Responds positively to change, embracing and using new practices or values to accomplish goals and solve problems. Respects and maintains confidentiality. Tells the truth and is honest in all dealings. Encourages and supports others at work. Focuses on results and desired outcomes and how best to achieve them in order to get the job done. Willingly puts in extra time and effort in crisis situations; goes the "extra mile" to ensure the goal is met. Defining tasks and milestones to achieve objectives, while ensuring the optimal use of resources to achieve those objectives.

Customer Service - Builds and maintains customer satisfaction with the products and services offered by CCHP. Meeting and exceeding customer needs while cultivating relationships that secure commitment and trust. Seeks customer feedback and ensures needs have been fully met. Be positive when interacting with customers. Delivers products and services when and where the customer needs them. Engages customer in identifying issues, options, and desired outcomes. Develops a clear picture of the needs and best options from the client/customers’ perspective. Remains committed to helping the client long after initial solutions have been applied. Follows up to make sure desired outcomes are realized. Acts proactively, recognizing important trends that will affect customers. Communicates those trends so clients can better prepare to meet new challenges. Develops new services and service models in line with those needs. Anticipates and recognizes the concerns of others, even if those concerns are not openly expressed. Provides excellent services to internal and external customers.

Qualifications

• Two years customer service or enrollment assistance experience; prior managed care experience
• Previously Certified as a Certified Application Assistor, desirable
• Results and detail oriented self-starter
• Passionate about helping resolve customer health care system access issues
• Excellent oral communication, customer service and organizational skills
• Fluent and literate in English and Cantonese or Mandarin or Spanish desirable
• Cantonese or Spanish preferred

Physical Requirements

• Able to lift up to 30 pounds
• Use proper body mechanics when handling equipment
• Standing, walking and moving 50% of the day.

Compliance Requirements

• Complies with CCHP Compliance Handbook including Code of Ethics and all statutes, regulations, guidelines applicable to federal and state programs. Responsibilities include, following the guidelines and reporting suspected violations of any statute, regulations, agreements or guidelines applicable to all healthcare programs.

Base Pay Scale

Starting at $24.00 - $25.00 Hourly

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, specialty and training. This pay scale is not a promise of a particular wage.