Medical Insurance Specialist

HEALTH INSURANCE NAVIGATOR

Responsible To: Director of Community Services

Job Status: Full-time, Exempt

Job Summary:

Three Rivers Youth (TRY) is a nonprofit organization dedicated to inspiring a consumer movement to increase access to quality, affordable healthcare in Southwestern Pennsylvania. The Health Insurance Navigator will assist individuals with public health insurance program enrollments, conduct community outreach, and provide transitional and community integration services for individuals at risk of, or who are residing in a County or Commonwealth of Pennsylvania facility or institution.

Job Duties:

Complete the CMS and agency-sponsored training program to become a licensed Pennsylvania Health Insurance Navigator. Complete intake and application process with consumers while maintaining the highest level of confidentiality. Increase awareness among our most vulnerable populations and provide them with the tools and resources needed to navigate access to healthcare. Plan and conduct community outreach, including attending health fairs, community days, back-to-school socials, and other enrollment events. Answer questions, schedule enrollment assistance appointments, conduct follow-up calls to ensure successful enrollment and coverage renewal, and make referrals to appropriate agencies as needed. Maintain ongoing knowledge of the rules and regulations of public health programs and the Affordable Care Act. Maintain a monthly outreach calendar, coordinate with on-the-ground partners to sustain grassroots community engagement at key city and community-led events. Create marketing materials (brochures, flyers, announcements) and contribute to organizational communications efforts. Meet target goals and deliverables; accurately collect data, and submit timely reports.

Complete the intake and application process for Medical Assistance or the Health Insurance Marketplace with inmates referred by jail staff before their release.

Assist with the completion of SSI/SSDI applications for inmates identified as having a disability and/or at risk of homelessness.

Provide inmates with information and resources needed to navigate access to healthcare.

Effectively complete Allegheny County Jail trainings.

Track enrollment numbers and compile written reports as required.

Conduct follow-up to ensure successful enrollment and renewal of coverage, make referrals to other health care resources such as free clinics, federally qualified health centers, voucher programs, pharmaceutical programs, etc., as needed.

Maintain ongoing knowledge of the rules and regulations of public health programs, including federally qualified health centers and patient assistance programs.

Participate in advocacy efforts, as needed.

Develop trusting connections with clients that foreground respect.

OTHER RESPONSIBILITIES:

1. Maintains 20 training hours per year.

2. Maintains open communication with supervisor and other staff as it relates to the necessary flow of the job and programs, and attends monthly staff meetings.

3. To be a flexible member of the agency's team to accomplish the overall agency goals.

4. Must possess and utilize excellent verbal and written communication skills and strong computer skills, including Windows, WORD, EXCEL, email, Internet, and other systems.

5. Multi-tasking skills: ability to work independently and as part of a team; comfortable with public speaking; dependable and mature.

6. Attends agency quarterly staff meetings.

Competencies:

• Promote a positive image of TRY with all contacts (customers)

• Exhibit high-quality work

• Be a productive member of the staff

• Demonstrate cooperation

• Take the initiative to act on one's own

• Use excellent judgment

• Communicate clearly

• Make use of supervision

• Contribute to the development of a culture of care

WORKING CONDITIONS:

The physical demands described here are representative of those that an employee must meet to perform the essential functions of this job successfully. While performing the duties of this job, the employee is regularly required to talk and hear. The employee is frequently required to stand, sit, and walk indoors and outdoors for long periods of time, weather permitting; use hands; and reach with hands and arms. The employee is occasionally required to carry, move, or transport employee files, records or other objects weighing as much as 80 lbs. Specific vision abilities required by this job include close vision and the ability to adjust and focus. Proper diction and command of the English language are required.

While performing the duties of this job, the employee will occasionally work in jail and office settings. The employee is required to travel by automobile to and from community events throughout the county.

Must be willing to work a flexible schedule in response to the needs of the target populations and may be required to work evenings and weekends. Time Keeping – Accurately record hours worked in the electronic timekeeping system in accordance with the timekeeping policy and practice.

A bachelor's degree in social work, public health, public administration, health administration, or a related field is preferred but not required; however, applicants must have a high school diploma or GED. Currently a Certified Health Insurance Navigator, or willing to undergo training to become a Certified Insurance Navigator. Demonstrated skills and two years' work experience in conducting community outreach. Sensitive and responsive to the cultural differences in various service populations. Having a strong knowledge base of the community, social services, the jail, or the welfare system is essential. Bilingual in English/Spanish is a plus; reliable transportation and a valid Pennsylvania driver's license, as well as current PA auto insurance, are required.

Act 33/34 Child Abuse Clearance, Pennsylvania Criminal History Clearance, and FBI Clearances are required.

This job reflects the assignment of essential and other responsibilities of this position. It does not prescribe or restrict the tasks that may be assigned. You may be asked to perform other related duties and other duties as requested and/or necessary.

Salary : $40,000 - $41,000