ADAP Enrollment Worker

Avenue 360 Health and Wellness•Houston, TX

11d

About The Position

The ADAP Enrollment Worker position primary responsibilities are typically; meet with new potential and established ADAP enrollees (i.e. the Texas HIV Medication Program or THMP), explain ADAP program benefits and requirements, assist clients and or staff with the submission of complete and accurate ADAP applications via the most efficient method available (e.g. the Public Health Information Network or PHIN), including ARIES. ADAP Enrollment Workers will ensure all annual Re-Certifications are submitted by the last day of the client’s birth month and semi-annual Attestations are completed six months later to ensure there is no lapse in ADAP eligibility and loss of benefits.

Requirements

Minimum a high school degree or equivalency.
Must have documented experience (paid, internship and/or as a volunteer) working with Persons Living with HIV/AIDS or other chronic health conditions.
Proficiency in the use of PC-based word processing and data entry to ensure ADAP applications and re-certifications are completed accurately in a timely manner.

Nice To Haves

Experience in performing intake/eligibility, referral/linkage and/or basic assessments of client needs preferred.
Bilingual (English/Spanish) preferred.

Responsibilities

Develop and maintain a process to track the status of all pending applications and promptly follow-up with applicants regarding missing documentation or other needed information to ensure completed applications are submitted as quickly as feasible.
Maintain communication with designated THMP staff to quickly resolve any missing or questioned application information or documentation to ensure any issues affecting pending applications are resolved as quickly as possible.
Identifying and screening clients including screening for third party payer and potential abuse; completing the comprehensive THMP intake including determination of client eligibility for the ADAP program in accordance with the THMP eligibility policies including Modified Adjusted Gross Income (MAGI).
Obtain, maintain, and submit the required documentation for client application including residency, income, and the THMP Medical Certification Form (MCF).
Conduct the 6-month attestations for all enrolled clients in accordance with THMP policies. Obtain, maintain, and submit to THMP all updated eligibility documentation.
Conduct annual Re-Certifications for enrolled clients in accordance with THMP policies. Obtain, maintain, and submit to THMP all updated eligibility documentation.
Proactively contact current ADAP enrollees 60-90 days prior to the enrollee’s re-certification or attestation deadline to ensure all necessary documentation is gathered to complete the re-certification/attestation on or before the deadline.
Ensure annual Re-certifications are submitted by the last day of client’s birth month, and semi-annual Attestations are completed six months later to ensure there is no lapse in ADAP eligibility and loss of benefits.
Provide initial education to applicants about the THMP including but not limited to: Discuss the confidentiality of the process including that THMP regards all information in the application as confidential and the information cannot be released, except as allowed by law or as specifically designated by the client. Applicants should realize that their physician and pharmacist would also be aware of their diagnosis. Discuss how applicants who have been approved by the THMP for assistance may be required to pay a $5.00 co-payment fee per prescription to the participating pharmacy for each month's supply at the time the drug is dispensed and the availability of financial assistance for the dispensing fee. Discuss how applicants who are eligible for Medicaid assistance benefits must first utilize and exhaust their monthly Medicaid pharmacy benefits in order to be eligible to receive medications from the Program. Medicaid eligible applicants shall be assigned to the nearest available participating THMP pharmacy outlet to receive medication. The pharmacy will not charge the $5.00 co-payment to the patient. Discuss the use of participating pharmacies and the procedure for how applicants will receive medications through the program.
Explains ADAP program benefits and requirements; and assist clients with the submission of complete, accurate APAP applications.
Track the status of all pending applications and promptly follow-up with applicants regarding missing documentation or other needed information to ensure completed applications are submitted as quickly as feasible.
Maintains communication with designated THMP staff to quickly resolve any missing or questioned application information or documentation to ensure any issues affecting pending applications are resolved as quickly as possible.
Works with case managers to ensure accuracy of ADAP application.
Documents all ADAP interactions ending in submission in both SUCCESS and ARIES
Create and maintain copies of all ADAP applications to safeguard clients confidentially and precise record keeping.
Scans all ADAP applications into ARIES.
Prepares and attends audits when requested.
Informs case managers of status of ADAP application via internal systems.
Submits completed applications via the most efficient method available (e.g. the Public Health Information Network or PHIN), including ARIES.
Ensures annual re-certifications are submitted by the last day of the client birth month, and semi-annual Attestations are completed six months later when possible.
Must document per TDSHS and Agency requirements all activities performed on behalf of ADAP enrollees including re-certifications and attestations.
Attend all ADAP trainings.
Implements an internal tracking system to allow team access to ADAP status.
Other duties as needed.