Certified Application Counselor (69764)

Employee Category: Non-Exempt | Reports to: Vice President of Patient Engagement & Projects

Character Qualities

• Patience – Accepting a difficult situation without giving a deadline to remove it.
• Availability – Making my schedule and priorities secondary to the wishes of those I serve.
• Enthusiasm – Expressing joy in each task as I give my best effort.
• Flexibility – Willingness to change plans or ideas without getting upset.
• Responsibility – Knowing and doing what is expected of me.

Responsibilities

• Demonstrates and maintains expertise in the eligibility and enrollment rules and procedures of the Health Insurance Marketplace and SoonerCare (Oklahoma Health Care Authority).
• Provides information and enrollment assistance to clients/patients in a fair, accurate, and impartial manner that is culturally and linguistically appropriate.
• Determines which coverage clients are eligible to apply for: Medicaid or ACA Exchange.
• Enrolls eligible clients in SoonerCare, Soon To Be Sooners, or any other available Medicaid program following OHCA rules and using Agency View.
• Assists clients/patients with setting up Marketplace accounts and navigating through the process of applying for a subsidy and selecting health insurance.
• Educates eligible clients/patients about terminology and responsibilities that may be unfamiliar to previously uninsured patients, including monthly premium obligations, co-pays, coverage options, as well as the new provisions for subsidies and individual tax credits intended to make the purchase of health insurance more affordable.
• Assists clients with making their own informed selection from the Marketplace health coverage options – never recommend which plan or option to select.
• Follows up with clients/patients as needed to assist with completion of enrollment.
• Assists clients/patients with Marketplace exemptions and appeals.
• Identifies internal enrollment barriers and coordinates with Variety Care staff to resolve issues.
• Identifies external barriers and shares with the Variety Care enrollment team for discussion.
• Informs clients about the range of medical, dental, behavioral health, WIC, and support services available at Variety Care and facilitates an appointment when appropriate.
• Performs public education and outreach activities to raise awareness about Medicaid, Marketplace, and the enrollment assistance available at Variety Care.
• Makes referrals to Variety Care and external social services resources as appropriate.
• Performs internal ECW and other documentation and reporting responsibilities as assigned.
• Supports Variety Care’s Patient Centered Medical Home approach and commitment to provide care to all Variety patients that is Safe, Effective, Patient Centered, Timely, Efficient, and Equitable.
• Collaborates to achieve the “Triple Aim” of healthcare reform goals – improve the experience of care for patients, improve health outcomes, and decrease healthcare costs.
• Embodies personal character, values open and honest communication, displays high moral and ethical conduct, integrity, adaptability, and sound judgment.
• Performs other duties as assigned.

Requirements

• High school diploma or GED.
• Fluency in both English and Spanish, with the ability to communicate effectively in both oral and written formats.
• Must complete CAC training and receive certification.
• Register with the Oklahoma Insurance Department as Navigator.
• Experience using a computer.
• Basic communication skills.
• Experience handling confidential information.
• Must have valid driver’s license and reliable transportation.

Preferred Qualifications

• Post-secondary education.
• Experience in community outreach work.
• Experience with SoonerCare Agency View.

Essential Functions

• Able to lift a minimum of 25 pounds.
• Able to drive to Variety Care sites and outreach locations.