ESSENTIAL JOB RESPONSABILITIESCaseload Management:
Provides outreach and enrollment assistance activities and facilitates enrollment of eligible health center patients and service area residents into affordable health insurance coverage through the Health Insurance Marketplaces, Medicaid, or the Children’s Health Insurance Program.
Demonstrates and maintains expertise in the needs of underserved and vulnerable populations
Creates rapport through patient interaction in order to facilitate services access planning and affordability options.
In coordination with the medical department and healthcare marketing unit ensures all new patients are adequately registered and financial eligibility challenges are addressed in order for the patients to return for their follow-up appointments.
Orients each assigned patient every time to agency services and provides information about how to access needed services.
In coordination with the medical department ensures new patients assigned by managed care plans are properly registered and oriented to agency services.
Enrolls assigned patients into available community programs and coordinates, supports, and follows up on every referral, every time.
Responsible for applying for SNAP programming on behalf of eligible patients.
Tracks referral success rates including a monthly, quarterly, and annual benefits analysis.
Serves as a liaison, coordinator, and/or advocate between various co-workers within the Case Management, Medical Care departments, or other community medical or agency service providers in order to remove barriers to accessing programming for assigned patients.
Uses knowledge of individual programs to conduct home visits, hospital visits and coordinates with other professionals or family members to apply for services as needed
Coordinates with physicians for appropriate benefit access.
Maintains a complete understanding of Insurances accepted by Care Resource providers and provides information to patients for their decision-making.
Maintains an organized and current system of tracking benefit applications to help patients remain compliant with applicable guidelines and follow up; all with the goal of maximizing available federal, state, and local services/benefits for individuals assigned.
Promotes health center services and coordinates patient enrollment by engaging in recruitment and retention initiatives with other departments as required
Service Planning and Documentation:
Ensures all documentation is Timely, Accurate, Legible, and Clear.
Develops comprehensive, individualized service access plans or plans.
Monitors patients to assess the efficacy of service plans and re-assesses and adjusts as necessary.
Empower patients to participate in their service planning.
Maintains service plans, benefit applications, and notes in patient records as specified in agency policy, program guidelines, and performance standards.
Coordinates with MMA Managed Care Coordinator on behalf of clients’ healthcare requirements.
Inputs patient information using electronic data entry according to agency and departmental guidelines.
Maintains an accurate record on timesheet reflecting time spent in each program worked (e.g. CM-FQHC 75 hrs, ACA 10 hrs).
Reports on total services value-added per patient monthly, quarterly, and annually (e.g. total successful benefits accessed per month for SNAP, Medicaid, Disability, ACA, etc.).
Prepares necessary program reports and records as requested by the supervisor and/or manager.Safety
Ensures proper handwashing according to Centers for Disease Control and Prevention guidelines.
Documents patient’s medications correctly, Makes sure each patient knows which medicines to take when they are at home, and encourages each patient to bring their up-to-date list of medicines every time they visit the doctor.
Ensures each new patient receives screening for their risk for suicide, the risk for depression, substance abuse, tobacco use, STIs and ensures treatment access for those in need.
Understands and appropriately acts upon assigned role in Emergency Code System
Understands and performs assigned role in Agency Continuity of Operations Plan (COOP)Other
Participates in staff training sessions within the timeframes specified and as required by the agency and the funding source.
Participates in agency developmental activities as requested.
Other duties as assigned.
- Case Management
- Children's Health Insurance Program
- Data Entry
- Decision Making
- Home Care