Exchange Enrollment Facilitator
About The Position
The Exchange Enrollment Facilitator (EEF) provides one-on-one assistance to people seeking coverage through Nevada Medicaid, Nevada Check Up, and Nevada Health Link Marketplace plans. The role supports consumers throughout enrollment, including applications, required documentation, eligibility issue resolution, renewals, redeterminations, and post-enrollment needs. It also provides education about health insurance, eligibility, reporting, and Medicaid community requirements. The position works primarily in community-based settings throughout southern Nevada, helping improve coverage access for uninsured, underinsured, and underserved populations. The facilitator conducts outreach and enrollment activities, maintains consumer records and regulatory compliance, and connects consumers to healthcare, financial assistance, and community resources. The schedule is flexible Monday through Saturday, including evenings as needed, and may vary with operational and business needs.
Requirements
- Fluency in English and Spanish.
- Valid Nevada driver's license with a clean driving record.
- Reliable transportation for travel to partner sites and outreach events.
- Strong computer skills, including Microsoft Office, EMR systems, data entry, and web-based applications.
- Ability to work occasional evenings and weekends to support community outreach and enrollment events.
- High school diploma or GED.
- Ability to obtain and maintain Nevada Exchange Enrollment Facilitator (EEF) certification within 60 days of hire.
- Strong communication, interpersonal, customer service, and organizational skills.
- Ability to build and maintain positive relationships with patients, staff, community partners, and stakeholders.
- Ability to work independently, manage multiple priorities and deadlines, and maintain confidentiality in accordance with HIPAA regulations.
- Ability to maintain integrity in a fast-paced, high-demand environment and meet performance, outreach, enrollment, and productivity goals.
- Ability to interact effectively and sensitively with people from diverse backgrounds, ages, cultures, and lifestyles.
Nice To Haves
- Experience with Medicaid, Medicare, Nevada Health Link, healthcare enrollment, community outreach, or related services.
- One year of experience in healthcare enrollment, community outreach, patient navigation, customer service, social services, or a related field.
Responsibilities
- Provide one-on-one enrollment assistance for Nevada Medicaid, Nevada Check Up, and Nevada Health Link Marketplace plans.
- Conduct eligibility screenings and assist consumers with applications, renewals, redeterminations, and required documentation.
- Resolve eligibility issues, application discrepancies, and enrollment barriers.
- Follow up with consumers about application status, documentation requirements, and renewal deadlines.
- Educate consumers about health insurance programs, benefits, eligibility requirements, and the Nevada Health Link portal.
- Respond professionally and efficiently to incoming calls, messages, and inquiries, and provide clear, compassionate guidance.
- Maintain positive relationships with patients, visitors, community partners, and staff.
- Conduct community outreach, enrollment events, educational presentations, and engagement activities.
- Represent the organization at community events, health fairs, enrollment drives, and outreach activities.
- Develop and maintain relationships with community organizations, healthcare providers, schools, churches, and social service agencies.
- Connect consumers with healthcare, financial assistance, and community resources as appropriate.
- Maintain compliance with Nevada Health Link, Medicaid, grant, and organizational documentation requirements.
- Document consumer interactions, enrollment activities, and case notes accurately in the EMR and designated systems.
- Comply with Nevada Health Link regulations, Medicaid requirements, HIPAA standards, and organizational policies; protect confidential information and maintain secure records.
- Stay informed about changes to Medicaid, Medicare, and Marketplace policies and procedures.
- Train and support staff on Medicaid, Medicare, Nevada Health Link, and insurance-related processes.
- Participate in staff meetings, trainings, quality improvement activities, and outreach initiatives.
- Meet or exceed enrollment, renewal, outreach, documentation, and productivity benchmarks.
- Perform other duties as assigned to support departmental and organizational objectives.
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What This Job Offers
Job Type
Full-time
Education Level
High school or GED
