Insurance Coordinator

Vivent Health•Milwaukee, WI

2d•$24

About The Position

The Insurance Coordinator provides a range of intensive, client-centered services to persons with HIV/AIDS. The primary role of the Insurance Coordinator is to ensure access to pay sources for health care through public benefits, private insurance, Marketplace Plans or other sources. This includes education, advocacy and assistance to clients and education of Social Services staff on insurance and benefit plan eligibility, changes and enrollment procedures. Other key roles include retention in health care and addressing medical, psychosocial, and other issues that present barriers to care through referrals to case management and to other needed services.

Requirements

Baccalaureate or graduate degree in social work, health care, or a human service discipline from an accredited college or university.
Minimum of two years’ experience offering direct client contact in a community based social service or health service agency.
Willingness to travel within the designated territory and willingness to work evenings and weekends as needed.
Valid Driver License, insurable driving record and access to a reliable insured vehicle
Knowledge of government benefit programs, private insurance, and Marketplace insurance
Knowledge of and sensitivity to the HIV/AIDS patient population, and/or an eagerness to learn about this community.
Knowledge of HIV disease and related issues, disease progression, and treatment options
Knowledge of medical, social and mental health delivery systems.
Demonstrated effective written and verbal communication skills, including assessment skills and providing effective presentations.
Ability to maintain effective organization of work and keep clear records.

Nice To Haves

Working knowledge of Spanish language (bilingual) is a plus.
HIV experience in a not-for-profit environment.

Responsibilities

Coordinate efforts to identify uninsured, and insurable, patients and clients statewide with the intent to connect them to a pay source for care, with the primary goal of adherence to HIV and primary medical care.
Gather information on the uninsured through Provide Enterprise, EPIC and QS1.
Working with the Director, assign appropriate case management staff to follow up with the uninsured, including assignment to the Insurance Coordinator for area clients and patients without a Case Manager.
Devote efforts during open enrollment periods for the Marketplace Insurance plans to reach clients and patients not only believed to be uninsured and eligible of Marketplace coverage, but also those who could benefit from a change in Marketplace plans.
Lead access to the Affordable Care Act (ACA) in the agency by directing the process annually, developing and maintaining policies and procedures, identifying strategies for enrollment, and ensuring statewide involvement.
The Insurance Coordinator will maintain a strong working knowledge of the ACA through training for Certified Application Counselors (CACs), attendance at relevant conferences and workshops, online reading, list-serves, and other available resources .
Educate case management and housing staff statewide on benefit and insurance issues.
Provide “benefits and insurance 101” training to newly hired case management staff.
Provide ongoing educational workshops to statewide case management staff to ensure they are current on changes and updates in benefit and insurance programs.
Act as a resource for staff navigating complex benefit and insurance issues with clients.
Directly assist uninsured patients with enrollment in medical care pay sources according to their income, residency and other eligibility factors, including programs available through the state (Medicaid, SSI, SSDI) and the Insurance Marketplace.
Educate clients and patients on insurance plan options that are in-network at key healthcare systems where they obtain care.
Assist clients and patients statewide with obtaining pay sources for care through client and patient workshops on benefits and insurance, offering appointment days for enrollment on-site at the four Medical Centers and two Pharmacies, and helping with mailings to clients about these issues.
Educate and enroll eligible patients in the Vivent Health HIV Medical Home during provision of insurance and benefit enrollment activities.
Ensure that that EPIC touches are accomplished for enrollment patients accessing assistance from the Insurance Coordinator.
Work with the Clinic Case Managers to optimize access to care by persons with HIV infection and to provide necessary education, support, referral and guidance so that patients can more readily improve their health status.
Help monitor insurance and benefit policy and government level changes to ensure that Vivent Health is on the forefront of insurance issues impacting client and patients.
Collaborate with VP of Government and Public Relations by communicating about policy changes that could have an effect on clients and patients and assist with macro level advocacy, as applicable.
Contribute as an active member of the Social Services department by participating in staff meetings, team meetings, client staffing meetings (when appropriate), in-service and training events; department planning activities, assisting in special projects, and providing support or peer mentoring as appropriate.
Inform clients of the services available through Vivent Health and in the community and refer and link clients to them as appropriate.
When needed, provide support to Case Management functions by assisting with provision of support services such as support groups, food pantry, housing assistance, school supplies, holiday gifts, volunteer services, transportation assistance, and financial assistance.
â Maintain appropriate client files and timely documentation of services utilizing electronic case management and/or medical software such as Provide Enterprise and EPIC.
Through ongoing training, reach and maintain a strong working knowledge of HIV/AIDS, treatment options, risk reduction techniques, chronic diseases, mental health issues, case management, insurance and benefit programs, and other related issues to better aid clients and patients.
Adherence to all agency policies, including Confidentiality, Employee Handbook, Health Care Corporate Compliance Plan, Standards of Conduct, and other relevant policies.

Benefits

Generous paid time off, including 12 paid holidays
401k with 100% employer match up to 5%
12 weeks of fully paid parental leave
Employer subsidized medical, dental, vision benefits, and gender-affirming care benefits
Employer paid short and long-term disability
Tuition reimbursement
Certification, and licensure assistance
Equity Practices: Fair treatment, access, and opportunities for all employees, creating an environment where everyone feels valued, respected, and empowered to contribute.
Professional Growth: Opportunities for professional development and advancement, along with training programs and events that promote cultural competence, unconscious bias training, and awareness.
Collaboration on an inter-disciplinary team: Within our integrated HIV care and prevention model, we employ a high level of collaboration across disciplines. That means that, in your role, you will have the opportunity to be exposed to whole person-care across medical, behavioral health, pharmaceutical, research, and more!
Delivery of quality patient care: Our integrated HIV care and prevention model is proven to help patients achieve positive health outcomes.