Job Summary:
This position is responsible for screening and patient eligibility for multi- programs offered at OFH such as Patient Protection, Affordable Care Act (ACA), Immigration Reform (IR), 3rd Party Payors, Family PACT, Every women counts, Sliding scale etc. The Patient Outreach and Enrollment Specialist are responsible for qualifying patients for financial coverage of services rendered. Patient Outreach and Enrollment Specialist (POES) services may include, but are not limited to, providing individuals and families with education about and assistance with the application process, case manage to ensure successful initial enrollments and annual renewal assistance. POES identify and develop relationships with strategic community partners (schools, service clubs, business, faith community, county staff, and other government agencies) and act as community liaison for OFH Outreach and Medi-Cal Retention programs. Represents OFH in the community and makes presentations at partner organizations and public forums regarding OFH outreach and enrollment initiatives. POES also establish and maintain relationships with County Departments of Social Services to facilitate applications and information sharing. The goal is to increase the number of individuals and families in California who are insured and have access to a Quality Health Plan.. Many patients are Spanish speakers and fluency in Spanish as well as familiarity with the regional Hispanic culture is required.
In addition, the ideal candidate must support mission and goal achievement, organizational quality and the patient-centered medical home philosophy we operate by. Incorporate core organizational values of quality, respect, integrity, partnership, and compassion in all activities and decisions. Perform community outreach and marketing to increase Omni Family Health (OFH) effectiveness in responding to the healthcare access needs of persons living in Kern County. Increase the number of area residents, especially those who qualify for the guidelines set by the Patient Protection and Affordable Care Act, who have access to primary and preventive health care services by identifying those eligible for publicly-sponsored insurance programs and other social services and assisting persons identified to navigate the enrollment process to secure needed services. Ensure that newly enrolled
members of publicly-funded insurance programs understand how their insurance plan works and have a functional relationship with an appropriate primary care provider. Protect the dignity, privacy, and confidentiality of patients and their families, as well as co-workers and others.
Job Duties:
Patient Outreach and Enrollment Specialist (POES) Tasks and Responsibilities (~75% of workload):
General Tasks
1. Possess excellent communication skills to relate with diverse populations, and community organizations.
2. Assist patients to accurately complete application(s) and successfully enroll/re-enroll into government sponsored health insurance programs or 3rd Party Payors, Family PACT, Sliding scale, Every Women countsetc.
3. Demonstrated ability to manage databases and spreadsheets
4. Demonstrated ability to work effectively with government and community partners
5. Experienced in the use of protected health information (PHI) to comply with HIPAA rules
6. Skilled in the use of personal computers and related software applications (MS Word, Excel, Access Database, and NextGen)
7. Provide follow up on all pending applications to ensure enrollment process is complete.
8. Provide Insurance and Medi-Cal financial counseling.
9. Follow-up on Medi-Cal enrollment.
10. Follow-up on Post-Enrollment management.
11. Outreach to raise awareness of the availability of Quality Health Plans.
12. Outreach to raise awareness of the availability and necessity of a Primary Care Provider
Qualifications, Education, and Experience:

EDUCATION:

· High school diploma.

· BA/BS in social services or health education, public health or other health related
field preferred.

EXPERIENCE:

· 1-3 years of experience in program development or other related field desired.

· Minimum two years working in a Primary Care Health Center, Healthcare related field, community or school based social service position. Work as a community health outreach worker and OHP enrollment specialist highly desirable.

CERTIFICATION:

· Certified Application Assistance (CAA) Certification - preferred

· CAA Certification can substitute for 1 year of experience.

Skills Requirements:

· Ability to pass a pre-employment drug screen and background test, Tb clearance.

· Dependable motorized transportation, valid driver’s license and proof of auto insurance.

· Knowledge of eligibility requirements and application process of all government sponsored health insurance programs.

· Ability to travel to work outreach and enrollment sites as required– must have reliable transportation.

· Current working experience in a Community Health Center setting.

· Knowledge of Kern County health care system preferred.

· Personal commitment to the organization’s mission, vision and core values.

· Personal commitment to the ACA, IR, and Patient-Center Medical Home philosophy.

· Bilingual (English/Spanish) preferred.

· Keyboarding at a minimum of 45 wpm.

· Skill in exercising initiative, judgment, problem solving and decision-making.

· Skill in the development and maintenance of effective relationship with medical and
administrative staff, patients and the public.

· Skill in gathering and analyzing objective and subjective data on personnel matters.

· Skill in conflict resolution.

· Skill in identifying problems, recommend solutions, organize and analyze information.

· Skill in organizing work, delegating and achieving goals and objectives.

· Skill in operating a variety of office equipment and computer programs.

· Skill to work under pressure, set priorities among multiple requests.

· Skill to communicate and present information effectively.

· Advance personal knowledge base by pursing continuing education to enhance professional
development.

· Non-judgmental attitude.

· Ability to work independently and as part of a team.

· Ability to plan, organize and integrate priorities and deadlines.

· Ability to work at a rapid pace, being involved in several duties at one time.

· Ability to set priorities and avoid crises management.

· Ability to remain calm and poised in urgent situations.

· Ability to communicate effectively in writing and verbally.

· Excellent time management skills and flexibility.

· Ability to report to work as scheduled.

· Demonstrated skills/knowledge of Microsoft Office suite.

· Ability to maintain confidentiality.

· Language Skills: Bilingual (verbal & written) in English and Spanish. Any third language a plus (relative to community need – e.g. Tagalog, Vietnamese).

· Excellent customer service skills – ability to understand and exceed customer expectations while demonstrating the highest standards of care, respect, and confidentiality.

· Demonstrated organizational, work management, and group process skills, ability to take initiative to identify and propose new tasks and procedures.

· Ability to establish and maintain working relationships with a diverse group of staff, public and professionals.

· Ability to manage time and prioritize tasks.

· Ability to proofread and edit for accuracy, punctuation, grammar, spelling, and clarity.

· Ability to demonstrate knowledge and competence in the use of software applications: word processing, spreadsheet, presentation, email applications (Microsoft Office preferred).

· Communication skills and the ability to work independently and collaboratively as needed.

· Must be able to maintain a good attendance record.

· Ability to relate effectively with people of different cultural backgrounds.

· Basic computer skills.

Responsible To: Patient Outreach & Enrollment Supervisor

Classification: Full Time Position, Non-Exempt