Health Insurance Counselor

The Connecting Kids to Coverage (CKC) Health Insurance Counselor under the supervision of the Health Insurance Services Program Manager is responsible for educating, assisting, and enrolling current Health Center patients, and non-patient consumers within Jackson and Clay Counties in MO in health insurance through Medicaid (MOHealthNet/CHIP). Candidates must complete all training required by the Centers for Medicare & Medicaid Services (CMS); the State of Missouri; the Missouri Primary Care Association (MPCA) and any other applicable federal and/or state training and licensing requirements related to assisting consumers in MOHealthNet/CHIP including receiving and maintaining access to the MEDES/FAMIS and EMOMED Medicaid eligibility systems. Candidates must complete a mandatory CMS Certified Application Counselor (CAC) training program and pass an online exam to ensure their understanding of the Health Insurance Marketplace and pass a background check and receive a State of Missouri Navigator License.

PRIMARY ACCOUNTABILITIES

Achieve Results

1. Take referrals of uninsured patients and perform outreach to identify non-health center patients within Jackson and Clay counties to educate, assist and/or enroll uninsured children, pregnant women, and families into MOHealthNet/CHIP.

2. Identifies community programs and resources and creates school-based and other community partnerships to get referrals of uninsured families with young children who need help applying for MOHealthNet/CHIP and enrolling or re-enrolling in MOHealthNet coverage at Annual Review.

3. Ability to travel and work at various Sam Rodgers clinics or at off-site locations throughout Jackson and Clay counties to achieve program and grant goals.

4. Explores alternatives and determines the best solution when trying to resolve customer service concerns.

5. Capacity to help consumers increase their health literacy by understanding their health insurance plans benefits; and how to use their health insurance to access the healthcare system.

6. Regularly use and maintain their access to the MEDES, FAMIS and EMOMED Medicaid eligibility systems to look up applicant information at the MO Family Support Division to help applicants apply, enroll, or renew their MOHealthNet coverage.

Operational Excellence

- Operate in a fiscally and socially responsible m anne r, upholding the image and goodwill of the organization and its mission at all times.

- Works in compliance and consistency with all laws, regulations, best practices, and other relevant standards.

Relationships

- Develops and maintains favorable internal relationships, partnerships with internal customers, patients, departments, and other internal parties.

- Develops and maintains favorable external relationships, partnerships with external clients, vendors, resources, funding sources, and related strategic and important contacts.

Leadership/Supervision, Stewardship Citizenship

- Sets an example for coworkers and in team development.

- Adheres to policies, guidelines, laws and is a good steward of resources and best practices.

Qualifications

PRIMARY TASKS & DUTIES

- Assist Health Center patients who are uninsured children, pregnant women or families and perform outreach to uninsured children, pregnant women, and families who are not patients of the Health Center within our service area in applying for MOHealthNet/CHIP.

- Help individuals to understand and access affordability options following all training guidelines.

- Provide information and assistance in a manner that is culturally and linguistically appropriate to diverse communities and accessible to individuals with disabilities.

- Create new school-based partnerships with school nurses and social workers in Jackson and Clay counties for referrals of uninsured children and families who need help applying for MOHealthNet/CHIP.

- Create partnerships with other community organizations such as Head Start programs, after-school programs, Local Initiatives Corp. (LINC), child care centers, and other organizations serving children and families for referrals of uninsured children and families who need help applying for MOHealthNet/CHIP.

- Assist uninsured children, pregnant women, and families with applying and enrolling or re-enrolling in MOHealthNet/CHIP pursuant to the Health Centers work plan.

- Network and establish a working relationship with social service and community-based organizations within our service area.

- Develop and give presentations for community groups and referral sources.

- Participate in community events such as school events, health fairs, and after-school events in order to promote health insurance options.

- Identify community partners to increase awareness of and enrollment in MOHealthNet/CHIP.

- Complete all federal Certified Application Counselor (CAC) training, state Ethics training and pass the online exam(s).

- Participate in federal, state, Cover Missouri Coalition, Missouri Primary Care Association training courses, meetings and webinars concerning MOHealthNet/CHIP or the Marketplace.

- Submit weekly program reports to the MO Primary Care Association and the Program Manager including but not limited to the total number of people educated, assisted, and enrolled or re-enrolled into health plans.

- Participate in occasional evening outreach events and/or weekend community health or school events as needed.

- Maintain strict confidentiality of all applicants personal information in keeping with HIPAA privacy regulations.

- Other duties as requested by supervisor.

ESSENTIAL FUNCTIONS/ KEY COMPETENCIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

1 . Customer Service

- Listens carefully to customer requests and concerns, maintains poise, patience, and respect for all patients/customers.

- Effectively manages conflicts and service issues with patients, their families, and fellow coworkers.

- Problem Solving

- Identifies customer service issues within the work unit.

- Identifies the causes of problems; does not overreact to the emotions of others.

- Explores alternatives and determines the best solution.

- Uses good judgment in resolving patient/consumer complaints.

- Professional

- Maintains poise and professional demeanor in all circumstances.

- Maintains a respect for process, and makes decisions based upon facts, not emotion.

- Analyzes job-related problems and determines appropriate action from available alternatives.

- Exercises good judgment with respect to the relative importance of work assignments and accepts responsibility for decisions and results.

- Interpersonal Skills

- Maintains and promotes cooperation among individuals and departments.

- Deals effectively with others regardless of level or status.

- Exhibits friendliness and is approachable.

- Understands and accepts individual differences.

- Communicates with others, and keeps others informed about matters of importance to them.

- Works Well with Others

- Resolves conflict effectively.

- Works collaboratively with peers.

- Involves the right people in decisions.

- Builds relationships beyond the work unit.

- Planning and Organizing

- Defines job-related objectives and effectively plans and organizes work to achieve them.

- Prioritizes activities, tasks, and problems that need to be addressed first by weighing their importance and urgency.

- Develops and uses efficient methods to meet deadlines and assure productivity.

- Dependability

- Is consistently present at and on time for work.

- Is punctual when returning from breaks, lunches, etc.

- Demonstrates reliable and conscientious work habits.

- Must have reliable transportation.

- Technical Competency/Functional Proficiency

- Demonstrates an understanding of all aspects of the job.

- Demonstrates sufficient technical competencies required of the position.

- Identifies errors and inconsistencies and corrects them.

- Understands and follows new policies, regulations, procedures, etc.

- Answers questions and shares new knowledge with others.

- Quality of Work

- Completes assignments with a minimum number of errors.

- Follows established policies and procedures when completing assignments.

- Demonstrates thoroughness and attention to detail.

- Submits work at consistent high levels of quality.

- Finishes assignments within established standards and deadlines.

- Ethics & Values

- Adheres to appropriate and effective set of core values and beliefs established by the organization.

- Is forthright, truthful, and trusted.

- Maintains social, ethical, and organizational values in conducting internal and external business activities.

POSITION REQUIREMENTS

Education and/or Experience

- Must be a high school graduate, GED certified equivalent, and have a minimum of an associate degree or at least two years of work experience in a healthcare organization; community outreach experience; or an understanding of the MOHealthNet/CHIP or KanCare program and/or the Health Insurance Marketplace.

- Bilingual ( Spanish or Vietnamese ) a plus.

- Must be able to type; computer literate; and able to generate reports and create presentations.

- Experience with Microsoft Office software.

- Must demonstrate an understanding of the socio-economic and health care problems of diverse low-income groups in a large metropolitan area.

- Ability to communicate effectively orally and in writing.

- Ability to effectively present information and to respond to questions.

- Must demonstrate accuracy, proficiency, and efficiency.

- Demonstrated ability to work effectively with the underserved and vulnerable populations.

- Knowledge of available community resources within the service area.

- Knowledge of affordable care and qualified health plans a plus.

- Must demonstrate tact, patience, and good communication skills in dealing with patients, Health Center staff, the public, external agencies, and organizations.

- Maintains a professional appearance and attitude.

- Maintain a valid drivers license, reliable transportation, and proof of insurance.

- Ability to travel & drive between Health Center site locations and service area as well as occasional Cover Missouri Coalition or MPCA meetings in Columbia, MO or Jefferson City, MO.

Physical/Environmental / Other

- The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

- While performing the duties of this job, the employee may be required to use their hands, stand, walk, talk, and hear; kneel, or reach with hands and arms. The employee is frequently required to sit, climb, or balance. The employee is frequently required to lift and/or move up to 10 pounds. Position requires close vision skills for computer usage and report reading. The ability to safely drive an automobile required.

- The work environment characteristics described herein are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

- The work is indoors and outdoors, working with other organizations, such as churches and government agencies. Most inside work is in a multicultural behavioral health and medical/dental health center, which delivers comprehensive healthcare services to the disadvantaged poor and underserved.

- The building is heated in the winter and air conditioned in the summer. The noise level is moderate to loud. Must be able to deal with several people talking simultaneously.

I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTAND THIS JOB DESCRIPTION AND THAT I AM QUALIFIED, CAPABLE AND PREPARED TO FULFILL THE DUTIES ASSIGNED.

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