Eligibility Specialist

Valley AIDS Council (VAC)dba Westbrook Clinic is the primary provider of specialty services, HIV prevention, education and testing services and supportive services in the lower Rio Grande Valley and surrounding areas.

Job Title: Eligibility Specialist - Non-Exempt

Reports to: Eligibility Coordinator

EMPLOYEE RISK FACTOR: III

Performs tasks that do not routinely involve exposure to blood, body fluids or tissues, or other potentially infectious materials and are not called on to perform or assist in emergency medical care or first aid to be potentially exposed in any other way as a condition of employment.

SUMMARY:

The Eligibility Specialist will screen the client to determine their eligibility for Ryan White services such as Ryan White Parts B, C, & D, State Services Funding, and the TMHP Drug Assistance Program. They will aid the client in getting all the proper eligibility documentation necessary to access Ryan White programs and ensure they apply for any other benefits and or entitlements. The Eligibility Specialist will also identify and help eliminate barriers to care by advocating and when necessary, act as a liaison helping clients navigate to complex landscapes of community services and resources. Eligibility Specialist plays a major role in keeping our clients in care and eliminating stigma through education and empowerment.

SUPERVISION RECEIVED:

1. Direct Supervisor: ADAP/Eligibility Coordinator

2. Department Director: Director of Client Relations.

3. COO

SUPERVISION EXERCISED

1. None

ESSENTIAL DUTIES AND RESPONSIBILITIES:

1. Must display excellent customer service skills, common courtesy maintaining eye contact and displaying active listening skills towards patients/clientele, staff, funders and the general public at all times.

2. Screen clients to determine eligibility for Ryan White services, maintain accurate documentation of said eligibility, and document outcome of services of said eligibility.

3. Assist clients in obtaining program eligibility documentation.

4. Provide information of RW services, Sliding Fee Scale and their responsibility and consequences of non-compliance.

5. Collaborate with Case Management staff to assist clients with identifying and referring them to other potential aid programs (Medicaid, Medicare, ACA, THMP).

6. Inform patients on accessing public benefits to ensure a smooth transition into all available services and minimize any initial disruptions to early intervention and continuity of care. This includes referring clients to sign up for applicable private health insurance, screening for social determinants of health to remove barriers, aiming at improved outcomes.

7. Educate clients on maintaining and understanding of said insurance coverage, responsibilities and benefits.

8. Serve as a liaison to assist within the agency and the outside benefits/community partners by developing collaborative relationships with individuals and organizations.

9. Advocate on behalf of the client when necessary to ensure access and successful linkage to benefits and entitlements.

10. Maintain client’s eligibility for Ryan White Program services every 6 months.

11. Maintain patient files and all necessary data entry in a timely manner and according to VAC policies.

12. Complete monthly reports with the number of services provided as required to meet or exceed the funder’s measures/requirements.

13. Complete monthly reports for THMP.

14. Participate in meetings and activities and annual trainings as required for agency and THMP Liaison.

15. Demonstrate good teamwork with fellow co-workers to achieve and complete daily tasks.

16. Maintains abreast of program requirements to comply with requirements and further the mission of VAC.

17. Participate in program improvement activities, meetings, and special projects as assigned.

18. Must participate in VAC/Westbrook Clinic special events including regular working hours.

19. Must abide by HIPAA regulations and confidentiality policies at all times.

20. Must follow all agency rules and regulations including but not limited to Employee Handbook and safety protocols and programmatic requirements.

21. Must attend departmental, organizational meetings and any mandatory agency and funder trainings.

22. Must provide staff coverage and travel from site to site.

23. Maintain a flexible schedule outside Monday - Friday 8:00 am - 5:00 pm, this position may occasionally require non-traditional hours, such as evenings and weekends and extended hours.

24. Occasional overnight travel.

25. Other duties as assigned and required.

MINIMUM QUALIFICATIONS – EDUCATION & EXPERIENCE:

· G.E.D. or High School Diploma is required.

· A degree from an accredited 4-year college or university program in the fields of allied health, social services, mental health or related field preferred but not required.

· Certified Community Health workers preferred but not required.

· 1 year of case management and or community health work experience with vulnerable populations including people living with HIV, and/or persons with a history of mental illness, homelessness, or chemical dependence; or any equivalent combination of education and experience.

· Experience in nonprofit, health settings, or service organizations.

· Reliable transportation, travel from site to site. Occasional overnight travel.

MINIMUM QUALIFICATIONS – KNOWLEDGE, SKILLS & ABILITIES:

· Must be able to work under conditions of constant interruption and be able to stay on task and attention to detail.

· Compassionate and empathetic with the ability to relate to target population from all walks of life.

· Ability to participate effectively as a team member and contribute to a positive work environment.

· Ability to demonstrate knowledge and work with diverse populations in the community.

· Ability to communicate effectively and with sensitive information.

· Knowledge of HIV/AIDS; knowledge of community resources and referrals; knowledge of OSHA regulations. Ability to work with people of diverse backgrounds living with HIV/AIDS.

· Working knowledge of Microsoft Office, specifically Outlook, Word & Excel, and general office procedures.

· Bilingual -Spanish and English to meet patients/clientele served.

· Skilled planner, organizational and time management skills.

· Ability to perform multiple tasks; good problem-solving abilities; demonstrate flexibility and positive skills.

· Knowledge and ability to safely operate a vehicle.

SPECIAL REQUIREMENTS/QUALIFICATIONS:

· Active Texas Class “C” Driver’s License. Automobile liability insurance. Must maintain all certifications, licenses and/or registrations consistent with VAC policy and Texas State Law.

EQUIPMENT USED:

Requires frequent use of personal computers, including word processing applications and spreadsheet programs; general office equipment and automobile.

PHYSICAL DEMANDS and WORKING CONDITIONS:

While performing the duties of this job, the employee is frequently required to sit and talk or hear. Eye strain due to constant use of personal computers. The employee is occasionally required to walk; use hands to finger, handle, or feel objects, tools, or controls; and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds with or without assistance. Specific vision abilities required by this job include close vision and the ability to adjust focus. Work is predominantly performed in an office setting, confined space where the noise level is usually quiet.

This job description should not be interpreted as all-inclusive or as an employment agreement between the employer and employee. It is intended to identify the essential functions and requirements of this job and is subject to change as the needs of the employer and requirements of the job change. Incumbents may be required to perform job-related responsibilities and tasks other than those stated in this specification.

Job Type: Full-time

Pay: $16.00 per hour

Benefits:

• 403(b)
• 403(b) matching
• Dental insurance
• Employee assistance program
• Flexible schedule
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Parental leave
• Retirement plan

Application Question(s):

• Will you be able to travel to other clinic sites to cover services on short notice or as needed?
• Will you be able to work extended hours or weekends?

Experience:

• Case management: 1 year (Preferred)

Language:

• English and Spanish (Required)

Ability to Commute:

• Harlingen, TX 78550 (Required)

Ability to Relocate:

• Harlingen, TX 78550: Relocate before starting work (Required)

Work Location: In person

Salary : $16