Insurance Coordinator

We’re on a mission to end HIV/AIDS through integrated, personalized, judgment-free care. That means meeting people where they are and supporting the whole person - medically, socially, and emotionally. Every role here plays a part in that mission. We believe healthcare works best when it’s rooted in equity, dignity, and access for all. At Vivent Health, we’re building a culture where every person - both patients and employees - feels seen, respected, and empowered to thrive.

About the role

The Insurance Coordinator provides a range of intensive, client-centered services to persons with HIV/AIDS. The primary role is to ensure access to pay sources for health care through public benefits, private insurance, Marketplace Plans, or other sources. This includes education, advocacy, and assistance to clients, as well as educating Social Services staff on insurance and benefit plan eligibility, changes, and enrollment procedures. Other key roles include retention in health care and addressing medical, psychosocial, and other issues that present barriers to care through referrals to case management and other needed services.

Responsibilities

• Coordinate efforts to identify uninsured and insurable patients and clients statewide with the intent to connect them to a pay source for care, with the primary goal of adherence to HIV and primary medical care.
• Gather information on the uninsured through Provide Enterprise, EPIC, and QS1. Work with the Director to assign appropriate case management staff to follow up with the uninsured, including assignment to the Insurance Coordinator for area clients and patients without a Case Manager.
• Devote efforts during open enrollment periods for Marketplace Insurance plans to reach clients and patients believed to be uninsured and eligible for Marketplace coverage, as well as those who could benefit from a change in Marketplace plans.
• Lead access to the Affordable Care Act (ACA) in the agency by directing the process annually, developing and maintaining policies and procedures, identifying strategies for enrollment, and ensuring statewide involvement.
• Maintain a strong working knowledge of the ACA through training for Certified Application Counselors (CACs), attendance at relevant conferences and workshops, online reading, list-serves, and other available resources.
• Educate case management and housing staff statewide on benefit and insurance issues. Provide “benefits and insurance 101” training to newly hired case management staff and ongoing educational workshops to ensure staff are current on changes and updates in benefit and insurance programs.
• Act as a resource for staff navigating complex benefit and insurance issues with clients.
• Directly assist uninsured patients with enrollment in medical care pay sources according to their income, residency, and other eligibility factors, including programs available through the state (Medicaid, SSI, SSDI) and the Insurance Marketplace.
• Educate clients and patients on insurance plan options that are in-network at key healthcare systems where they obtain care.
• Assist clients and patients statewide with obtaining pay sources for care through client and patient workshops, offering appointment days for enrollment on-site at the four Medical Centers and two Pharmacies, and helping with mailings to clients about these issues.
• Educate and enroll eligible patients in the Vivent Health HIV Medical Home during provision of insurance and benefit enrollment activities.
• Ensure that EPIC touches are accomplished for enrollment patients accessing assistance from the Insurance Coordinator.
• Work with Clinic Case Managers to optimize access to care by persons with HIV infection and to provide necessary education, support, referral, and guidance so that patients can improve their health status.
• Help monitor insurance and benefit policy and government-level changes to ensure that Vivent Health is at the forefront of insurance issues impacting clients and patients.
• Collaborate with VP of Government and Public Relations by communicating about policy changes that could affect clients and patients and assist with macro-level advocacy, as applicable.
• Contribute as an active member of the Social Services department by participating in staff meetings, team meetings, client staffing meetings (when appropriate), in-service and training events, department planning activities, assisting in special projects, and providing support or peer mentoring as appropriate.
• Inform clients of the services available through Vivent Health and in the community and refer and link clients to them as appropriate.
• When needed, provide support to Case Management functions by assisting with provision of support services such as support groups, food pantry, housing assistance, school supplies, holiday gifts, volunteer services, transportation assistance, and financial assistance.
• Maintain appropriate client files and timely documentation of services utilizing electronic case management and/or medical software such as Provide Enterprise and EPIC.
• Through ongoing training, reach and maintain a strong working knowledge of HIV/AIDS, treatment options, risk reduction techniques, chronic diseases, mental health issues, case management, insurance and benefit programs, and other related issues to better aid clients and patients.

Requirements

• High school diploma or GED.
• Working knowledge of Spanish language (bilingual) is required.
• Minimum of two years’ experience offering direct client contact in a community-based social service or health service agency.
• Willingness to travel within the designated territory and work evenings and weekends as needed.
• Valid Driver License, insurable driving record, and access to a reliable insured vehicle.
• Knowledge of government benefit programs, private insurance, and Marketplace insurance.
• Knowledge of and sensitivity to the HIV/AIDS patient population, and/or an eagerness to learn about this community.
• Knowledge of HIV disease and related issues, disease progression, and treatment options.
• Knowledge of medical, social, and mental health delivery systems.
• Demonstrated effective written and verbal communication skills, including assessment skills and providing effective presentations.
• Ability to maintain effective organization of work and keep clear records.

Preferred Qualifications

• HIV experience in a not-for-profit environment.

Pay

$24.00/hourly - $26.00/hourly (Depending on Experience). The final salary will be determined based on factors such as market data, internal equity, candidate experience, and qualifications.

Benefits

• Generous PTO, including 12 paid holidays.
• 401(k) with 100% employer match up to 5%.
• 12 weeks fully paid parental leave for benefits-eligible employees after one year.
• Employer-subsidized medical, dental, vision, and gender-affirming care.
• Tuition reimbursement and licensure assistance.
• Benefits for full-time and eligible part-time roles.
• Public Student Loan Forgiveness eligibility. Employment at our organization may qualify you for federal student loan forgiveness programs.