Job Description

Job Title:                           Outreach & Enrollment Program Supervisor

Reports To:                       Patient Access Manager

Job Summary:                  Services clientele by screening for medical coverage eligibility available with various programs; educates and assists with the application and enrollment process. Supervises and directs Outreach & Enrollment Specialist and manages and coordinates the Outreach & Enrollment Program.

                                                                                                                                                                       

Essential Job Duties and Responsibilities:

The job duties and responsibilities listed below are representative of the knowledge, skill, and/or ability required.  Other duties that fall within the broad scope of this classification may be assigned.

  • Assists Patients in Determining Medical Coverage Eligibility
  • Utilizes demographic data to determine patients’ eligibility for Medicare plans and complementary plans. Reaches out to these patients and assists them with enrollment.
  • Coordinates Medicare annual well visits for new enrollees.
  • Helps enrollees determine if dually Medicare/Medicaid eligibility for elderly or other qualifying individuals.
  • Uses available means to actively reach out to the community to inform the public of Marketplace, Medicare and Medicaid programs that are available to eligible enrollees with an emphasis on elderly patients.
  • Utilizes the Health-E-Arizona plus program to screen applicants for Medicaid/ CHIP program and other discount medical programs.
  • Educates applicants on requirements, application process, and services provided by health care programs.
  • Assists patients/clients with the health care program application process.
  • Tracks application progress for completion through continued contact with the client.
  • Maintains current status of work in progress.
  • Assists patients with applications for Sliding Fee Discount Program.
  • Working assigned weekends is required.

 

  • Provides Outreach and Enrollment Program Supervision
  • Supervises Outreach and Enrollment Specialists, training them and auditing their duties.
  • Assists in overall development of the CCHCI of Outreach and Enrollment Program.
  • Provides customer service and operational training, hands-on coaching, and other staff development tools and resources to O&E staff.
  • Monitors performance of O&E department to ensure it operates in an efficient and consistent manner and that the patients receive high quality customer service.
  • Assesses department needs and participates in the development of policies and procedures regarding O&E.
  • Ensures operations are following CCHCI policies and procedures as well as all local, state, and federal laws and regulations.
  • Facilitates training new hire staff on Sliding Fee Discount Program, 340B Program and O&E services.
  • Ensures O&E staff is up to date on insurance licensing requirements and annual CAC certification, and are updated on all federal, state, and local laws, policies, and rules regarding enrollment.
  • Reports quarterly reporting requirements for Health Resources and Services Administration (HRSA).
  • Conducts monthly Health-e-Arizona Plus audits to ensure that all sliding fee documentation has been obtained and scanned into the system correctly.
  • Conducts liaison, and provides education and presentations to community organizations, agencies and businesses on Medicaid/CHIP and other community discount medical programs available.
  • Implements daily audit system.

 


Minimum Qualifications - Education, Experience, Certificates & Licenses:

  • Associates in psychology, social work, medical case management, nursing, healthcare administration, public health, business management or a related field
  • Annual Health-E-Arizona plus and Certified Application Counselor Certification renewals are required.
  • Any combination of education and/or experience that provides the necessary skills.
  • Driver's License and Proof of Insurance may be required if requesting mileage reimbursement.
  • Valid Fingerprint Clearance Card.

 

Preferred Qualifications – Education, Experience, Certificates & Licenses:

  • Bachelor’s Degree in psychology, social work, medical case management, nursing, healthcare administration, public health, business management or a related field preferred.
  • Supervisory or other leadership experience preferred.

Required Language Skills:

  • Ability to comprehend and compose instructions, correspondence, and communications in English in both oral and written format.
  • Bilingual in English and Spanish preferred, but not required.
  • Ability to effectively present information in one-on-one and small group situations to patients, internal providers and staff and other agency staff working in cooperation with the organization.

 

Physical Requirements:

  • Ability to occasionally exert enough force to move objects weighing up to 10 pounds.
  • Ability to continuously remain in a stationary position.
  • Ability to occasionally move about inside the workplace to access files, office machinery, etc.
  • Possesses hand-eye coordination and manual dexterity necessary to constantly operate computer, telephone, and other office machinery.
  • Possesses close visual acuity necessary to accurately record and view information on a computer monitor, handwritten and typed documents.
  • Ability to discern the nature of sounds at a normal spoken volume.

 

Other Required Knowledge, Skills, and Abilities:

  • Ability to add, subtract, multiply and divide in all measure, using whole numbers, common fractions, and decimals.
  • Ability to compute rate, ratio, and percent and to draw and interpret graphs.
  • Ability to skillfully gather and analyze data.
  • Ability to perform a variety of assignments and make decisions requiring considerable independent judgment.
  • Displays high level of critical thinking and problem-solving skills.
  • Knowledge of community medical discount programs preferred.
  • Knowledge of health care programs available through state and federal programs, such as Medicaid/AHCCCS/CHIP programs required.
  • Knowledge of HIPAA and Corporate Compliance rules and regulations.
  • Knowledge of health plans in general, experience working with Medicare and Medicaid.
  • Computer literacy required with proficiency in use of all Microsoft Office programs.
  • Ability to employ motivational techniques to train, mentor, and lead staff.

 

Work Environment & Conditions:

  • Work environment is typical of an administrative office setting with work occasionally performed outdoors with exposure to outside weather conditions to include heat and cold, and humid, windy, and dry conditions.
  • Work environment frequently includes patient contact with occasional exposure to communicable diseases, bodily fluids, and hazardous chemicals.
  • Work includes occasional driving in normal and adverse weather conditions over improved and rough road surfaces.
  • Work requires reliable transportation as position requires occasional travel and extended hours to include early mornings, evenings, and weekends for community outreach events.
  • Work requires ability to be contacted by cell phone during or outside of regular work hours.