The Outreach and Enrollment Counselor will perform outreach and 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, and Children’s Health Insurance Program/Healthy Families.
Consults with and advises the Director of Health Education regularly regarding outreach and 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, 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.
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 and tracking outreach and enrollment information to prepare outreach and enrollment reports.
As needed translate written material related to the outreach and 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 outreach events.
Attends and participates in staff meetings and training as required by Supervisor.
Responsible for distribution of materials, forms, and reports
Performs other tasks as assigned
High School Diploma or GED
One (1) year experience working in a health care program providing health insurance coverage information.
Knowledge of geographical area and ethnic communities
Ability to type 35 words per minute
Ability to communicate effectively in English and Spanish or English and Hmong written and verbal.
Ability to comply and successfully complete all required and applicable federal and state consumer assistance training.
Valid California driver's license, proof of auto insurance, and personal transportation
Knowledge of health insurance programs
Knowledge of community resources and referral agencies
Knowledge of computer systems and applications
Knowledge of grammar, spelling and punctuation to compile and type reports
Knowledge of instructional skills and educational techniques to guide consumers
Skill in establishing and maintaining effective working relationships with consumers, staff, and various agencies
Skill in public speaking
Ability to identify problems, provide information, and recommend solutions
Ability to prepare routine reports using terminology common to outreach employees
Ability to Interpret, adapt, and apply appropriate written guidelines and work practices
Listens skillfully and displays a willingness and ability to acknowledge the needs, expectations, and values of others by using reflective listening and empathy conveyance. Responds to needs in ways that are helpful and beyond expectation.
Communicate effectively by using welcoming words, proper tone of voice, appropriate body language, eye contact and smiling with every interaction.
Ability to provide excellent customer service that is reflective of a culture that values trust and respect.
TYPICAL PHYSICAL DEMANDS: May require sitting for long periods of time. Occasional bending, stretching or lifting. Requires frequent walking and standing for prolonged periods of time. Lifts and carries items weighing in excess of 50 pounds. Vision must be correctable to 20/40 and hearing must be in the normal range for telephone contacts. Requires the ability to work under demanding conditions. Requires ability to drive to outreach areas for presentations and other activities. May require working week nights and weekends.
TYPICAL WORKING CONDITIONS: Normal office environment and work performed outside where exposure to rain, heat, dust, wind, pesticides, pollens, and other weather demands common to a labor camp, park, community center or health fair. May include exposure to individuals who are violent, abusive and/or under the influence of alcohol or drugs.