Outreach & Enrollment Specialist

Education/Experience/Skills

• High School Diploma or equivalent.
• Two to four years of customer service experience and understanding of the basic principles of managed care and the concepts of publicly financed health insurance such as Medicaid and CHIP programs.
• Current licensed healthcare navigator preferred.
• Valid Georgia driver license required.
• Must be competent in Microsoft software applications.
• Excellent communication (telephone, email or in person), organizational and customer service skills.
• Excellent phone etiquette.

• Ability to communicate effectively in a team environment.
• Ability to speak effectively in front of large audiences.

Math Ability

• Basic mathematical skills.

Reasoning Ability

• Ability to multi-task and prioritize.
• Demonstrate good judgment and decision making skills.

• Create materials and conduct extensive outreach to inform community of available health plans and other health services.
• Applies health insurance guidelines to determine client eligibility for participation.
• Provides assistance in determining eligibility for coverage options and facilitating enrollment in affordable health coverage.
• Conduct public education activities to raise awareness about coverage options available under Medicaid, CHIP and the Marketplace.
• Required to coordinate and collaborate with other CHC’s, Primary Care Association (PCA) and local resources to provide better assistance to potential members and to prevent duplication of efforts.
• Locate upcoming events at which to conduct outreach activities, and maintain calendar of such events.
• Responds to telephone, written and in-person inquiries and initiates steps to assist regarding issues relating to content or interpretation of benefits, policies and procedures.
• Provides timely and accurate resolution of inquiries and issues regarding benefits, services and policies.
• Work directly with front office, billing and clinical staff to assure patients are assessed for health insurance eligibility to include sliding fee scale where applicable.
• Assess clients’ involvement in services, identify barriers to care and readiness to access care and work with clients to eliminate barriers where applicable.
• Provide education to health center staff at all sites regarding insurance options so that they can assist in educating their patients/clients
• Provide educational material regarding insurance options and organization’s services to community partners including health departments, hospitals, urgent care and human services agencies and coordinate outreach efforts with these groups
• Identify and engage with key community leaders and relevant organizations whose work is aligned with the vision and mission of Oakhurst Medical Center.
• Supports and promotes Federal, State, Primary Care Association (PCA) and local Sponsored Programs through participation in community events. Supports member access to care through processing of reports and distribution of collateral materials.
• Helps individuals understand and access affordable healthcare options.
• Provide resources for social support services.
• Provides information and assistance in an impartial manner and that is socially, culturally and linguistically appropriate to diverse communities and accessible to individuals with disabilities.
• Keep up to date with developments in outreach and enrollment by reading relevant material, going to meetings and completing applicable trainings.
• Obtain and maintain required certifications, and licensure.
• Available to work evenings and weekends as required to meet program goals.
• Actively identifies and pursues opportunities for team involvement.
• Contribute to overall team effort by completing other duties as assigned.
• Completes all required documentation and reporting as needed or requested.