Public Benefits Health Exchange Director

Company Description

Mary's Center is a federally qualified health center that served over 35,000 men, women and children in 2014. We provide comprehensive health, dental, social, and education services to underserved, underinsured, and uninsured individuals in the D.C. metropolitan region. Our mission is to build better futures through the offering of these services. We embrace culturally diverse communities and provide them with the highest quality of care, regardless of ability to pay.

Job Description

The Bilingual Health Access Program Manager [BHAP] ensures that all participants lacking insurance are screened for eligibility and assisted in applying for benefits as applicable. The position works in partnership with our funders, including the Office of Latino Affairs and the Department of Human Services, to ensure adherence with all protocols and best practices. The position also provides oversight and supervision to the DC Health Link supporting adherence to the requirements of enrolling DC residents in the Health Exchange and/or Medicaid programs available. Supervision of staff and report writing is part of this role.


ESSENTIAL DUTIES & RESPONSIBILITIES:  

Include the following. Other duties may be assigned.

Health Insurance Screening

• Screens participants for public benefits, counseling participants on the range of benefits for which they may be eligible and assisting in the completion of new medical assistance applications.

• Tracks the status of pending applications, advocating for participants with government offices as necessary and identifying matters that should be referred to social services for further action and advocacy.

• Builds and maintains successful working relationships with appropriate public benefit and community based agencies in the District including OLA and DHS as well as others as identified

• Identifies areas to provide outreach in the community educating them on their benefits and how to apply.

• Provides education to Mary’s Center staff on local resources and changes to benefits as they occur.

• Works directly with MCO representatives to resolve any patient insurance issues, such as changing plans or assigning a PCP.


Management

• Provides supervision to staff that work directly with participants to screen for insurance eligibility. Supports all Health Link staff in obtaining necessary certification to provide the service in the District.

• Meets regularly with staff, at minimum biweekly, to review performance of previous week, ability to reach targeted objectives and trouble shoot any areas of concern

• Evaluates staff performance annually and as indicated to provide positive feedback and corrective actions as needed.

• Develops MOUs with partnering agenc(ies) with which we may provide Health Link and/or BHAP activities

• Assembles all necessary documentation and data for reports. Provides both quantitative data as well as narrative reports to funders

• Attends all Health Link and/or BHAP meetings, helps to schedule staff to participate in necessary Outreach and/or Enrollment Events

• Monitors supply needs of staff and supports staff in having those items necessary for their role.


General 

• Provide and model outstanding customer service to our participants and the public

• Follow HIPAA confidentiality guidelines

• Perform other duties as determined necessary by the Vice President of Programs

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

Education and/or Experience – Bachelor’s Degree or Equivalent Experience. Must possess experience working in a fast paced setting and able to operate independently. Experience in a medical setting preferred, working directly with clients, knowledge of public benefits programs and eligibility standards in the District. Must also have ability to negotiate/provide advocacy, and communicate effectively in English. Bilingual Spanish/English or Amharic/English a must. Must have a thorough understanding and working knowledge of patient confidentiality issues and HIPAA compliance/regulations.

Reasoning Ability – Ability to apply common sense understanding to carry out moderately-complex, multi-step instructions and make appropriate independent decisions as necessary 

Physical Demands –Regularly required sitting as well as be walking for community outreach; frequently required to reach with hands and arms, walk, stoop, kneel, crouch, talk or hear; must be able to lift objects up to twenty-five (25) pounds. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

Work environment – Mostly in a typical office setting with quite to moderate noise level. May be exposed to wet and/or humid conditions. May be exposed to extreme cold, heat, and humidity due to outside weather conditions.  

Additional Information

All your information will be kept confidential according to EEO guidelines.