Family Health Advocate (Elk Ridge) - Winslow - Family Medicine

El Rio Community Health Center•Winslow, AZ

About The Position

The Family Health Advocate performs administrative duties and eligibility processing in support of Elk Ridge Community Health services and operations. The role determines eligibility for services, assists with applications, and provides information to clients and staff about community, government, and private social services, agencies, and programs. The position supports consumer recruitment, registration, enrollment, and retention for ACA Marketplace, AHCCCS, and discount programs, and makes referrals to social services and agencies. Working with intermittent supervision and review, the Advocate researches healthcare program requirements, shares information and training with staff, assists consumers with enrollment through web-based systems, and provides reporting and operational support. The role also serves as a liaison and informational resource, conducts presentations and community outreach, and supports compliance with confidentiality, organizational policies, and Joint Commission requirements. The position requires a high school diploma or GED and three years of directly relevant experience. Upon employment, the employee must obtain and maintain Certified Application Counselor certification for the Affordable Care Act.

Requirements

High school diploma or General Education Diploma (GED).
Three years of experience working as a Family Health Advocate (Elk Ridge), Eligibility Assistant, Outreach Worker, or Certified Application Counselor for the Affordable Care Act.
Obtain and maintain certification and licensing as a Certified Application Counselor for the Affordable Care Act upon employment.
Have a current, valid Level I fingerprint clearance card in good standing, or apply for one within seven working days after beginning employment.
Have reliable transportation capable of meeting operational reassignments during the workday.
If driving during work hours, possess a valid driver's license and comply with Arizona vehicle insurance requirements.
Undergo drug testing prior to employment and comply with applicable post-accident, reasonable suspicion, return-to-duty, and follow-up drug and alcohol testing.

Nice To Haves

Bilingual English/Spanish skills, including the ability to speak, read, and write in both languages.
An equivalent combination of education and experience may be considered if directly related to the job's functions and responsibilities.

Responsibilities

Perform administrative duties and eligibility processing in support of departmental operations.
Determine eligibility for services and assist consumers with applications and enrollment in ACA Marketplace, AHCCCS, and discount programs.
Maintain advanced knowledge of governmental and private healthcare programs, including the Affordable Care Act, Healthy Arizona Plus, and Sliding Fee Scale.
Conduct research and provide informational summaries and training on healthcare programs and regulatory changes.
Train and mentor new and existing staff, including facilitating annual refresher or recertification training.
Participate in reviewing and developing operational policies and procedures and recommend process improvements.
Perform all functions, duties, and responsibilities of an Eligibility Assistant.
Provide timely and accurate eligibility lookups, system-generated reports, and data collection on outreach and operational activity.
Support consumer access and enrollment through HEAPlus and ACA Marketplace web-based applications and systems.
Generate and distribute reports, summaries, and correspondence; enter information into systems, software, or spreadsheets.
Explain eligibility options and requirements and provide enrollment assistance for programs such as Medicaid (AHCCCS) and the ACA Marketplace.
Respond promptly and effectively to calls, emails, inquiries, requests for support, technical questions, and complaints.
Serve as a liaison to internal departments and staff for eligibility-related problem-solving and in-service training.
Conduct informational presentations and public speaking for community groups and individuals about eligibility services.
Create presentations and materials that meet CMS guidelines and approval requirements.
Participate in community events promoting health and awareness of available programs and services.
Process operational activity in program systems or spreadsheets to support tracking, reporting, and invoicing of application completion and production.
Maintain proficiency with organizational systems and software and adapt to upgrades and changing requirements.
Maintain a clean, safe, and hygienic work environment and follow applicable policies, infection prevention, and Joint Commission requirements.
Maintain confidentiality and comply with HIPAA, corporate compliance, organizational policies, and standards of conduct.
Represent Elk Ridge Community Health professionally and participate in appropriate local, state, and national healthcare activities.
Use organizational materials, supplies, and equipment cost-effectively and limit waste.
Accurately document hours worked and obtain timely approval.
Perform other duties as assigned.