Health Coverage Counselor

At Community Medical Centers (CMC), we’re passionate about improving health and well-being in the communities we call home. That’s why we work to ensure even our most vulnerable neighbors have affordable access to quality healthcare, regardless of age, income, or background. We offer integrated medical, dental, behavioral health, and supportive services, with a model of care that puts the patient at the center of a team-based approach. As one of the region’s largest healthcare providers, our growing network of neighborhood health centers serves over 100,000 patients in San Joaquin and Solano counties.

MISSION

Working together to improve health and well-being in our communities.

BENEFITS

• Competitive Pay
• Medical, Dental, & Vision benefits options for full-time employees
• Flexible spending account for medical expenses
• Dependent care
• Employee assistance program
• Life Insurance
• Pet Insurance
• Short Term/Long Term Disability Insurances
• 403(b) retirement saving plan with company match
• 10 paid sick days/12 Holidays/Vacations days vary on position
• In Shape Discounted Gym Membership
• Excellent growth and advancement opportunities
• Collaborative and diverse environment

POSITION SUMMARY:

The Health Coverage Counselor will perform enrollment assistance activities that facilitate enrollment of eligible health center patients and service area residents into affordable health insurance coverage through the Health Insurance Marketplaces, Medicaid, Children’s Health Insurance Program/Healthy Families, Medicare, and other payors

SPECIFIC DUTIES:

• Promotes the mission, vision, and values of the organization.
• Consults with and advises the Membership Services Director regu­larly regarding insurance enrollment activities.
• Responsible for scheduling and conducting educational presentations to groups or individuals in the communi­ty on health insurance options and utilization of benefits.
• Assist in all parts of the insurance enrollment process such as educating consumers about affordable coverage options, setting up a profile in the Covered CA Portal, filing affordability assistance information, receiving an eligibility determination, and/or enrolling in affordable health insurance.
• Maintain expertise in eligibility and enrollment rules and procedures, the range of qualified health plan options and insurance affordability programs, the needs of underserved and vulnerable populations, and privacy and security standards.
• Conduct public education activities to raise awareness about coverage options under Medi-Cal, Medicare, CHIP and the Covered CA Marketplace.
• Assist individuals with understanding and accessing affordable options, provide information and assistance in a fair, accurate and impartial manner, provide information and assistance in a manner that is culturally and linguistically appropriate to diverse communities and accessible to individuals with disabilities.
• Assist individuals in information about available health and social services at Community Medical Centers and the community.
• Provide referral to any applicable office of health insurance consumer assistance or ombudsman established under Section 2793 of the PHS.
• Act to address consumer grievances, complaints, or questions about their health plan, coverage, or a determination.
• Responsible for collecting, tracking and entering enrollment information to prepare enrollment reports.
• As needed translate written material related to enrollment.
• Serves as departmental representative at various meetings when assigned.
• Assists with various health insurance activities as assigned and works as a team member to ensure success of enrollment and advocacy events.
• Attends and participates in staff meetings and train­ing as required by Supervisor.
• May assist Patients Services Center and Population Health as directed.
• Responsible for distribution of materials, forms, and reports
• Performs other tasks as assigned