AAA Medicare Insurance Counselor (SHIP) Case Manager

Pikes Peak Area Council of Governments•Colorado Springs, CO

4d•$57,000 - $59,000

About The Position

This is an exempt position with the Pikes Peak Area Council of Governments, Area Agency on Aging (PPACG AAA) Senior Information and Assistance Center. This is a cross-trained position to provide Medicare or Case Management services as needed. As a Medicare counselor you will provide free, unbiased, one-on-one counseling to Medicare-eligible individuals, families, and caregivers, help beneficiaries navigate Medicare options (Parts A, B, C, D), Medigap, long-term care insurance, and assist with enrollment, claims, appeals, and fraud detection. As a Direct Services Case Manager you will provide case management services including performing interviews, assessments, and intake of clients to determine needs, develops, explains, and provides follow-up care plans, coordinates the exchange of information and provision of client services with other agencies, conducts on-site visits, determines appropriate resources and makes referrals to both internal and external programs, and provides training and community education for groups and individuals.

Requirements

Bachelor’s degree in a human services curriculum plus a minimum of 2 years of progressively responsible experience with an agency serving human services needs, providing counseling or case management, or
Associate’s degree in a human services curriculum plus a minimum of 4 years of progressively responsible experience with an agency serving human services needs, providing counseling or case management, or
May have commensurate work experience of 6 years in lieu of a degree
Microsoft Office software programs and ability to learn new computer software.
Local and state laws relating to senior legislation.
Successful completion of mandatory state SHIP counselor training and certification.
Age and disability related issues and concerns of adults, their families, and caregivers.
Strong oral and written communication skills.
Good interviewing, observation, and note taking skills.
Effectively communicate to match client needs with appropriate services.
Remain objective and empathetic.
Display adequate conflict resolution and deescalation skills.
Manage complex analytical tasks.
Ability to be flexible and respond quickly and effectively to changing work assignments.
Capacity to handle confidential information.

Nice To Haves

Prefer knowledge of community resources for the elderly, caregivers and the disabled as well as understand basic services such as housing, utilities, medical, homemaker, personal care, etc. Understand agency contracted provider services.

Responsibilities

Provide personalized counseling on Medicare benefits, enrollment periods, Medicare Advantage Plans (Part C), and Prescription Drug Plans (Part D) plan comparisons
Screen for and assist with enrollment in low-income subsidy programs like Medicaid, Medicare Savings Programs, and Extra Help, Long Term Care, and other programs.
Act as a beneficiary advocate, help resolve billing errors, and educate on spotting Medicare fraud or scams, investigate reported problems in service or assistance with Social Security, Medicare, Centers for Medicare and Medicaid Services (CMS), and Medicaid, author appeals, requests for review, and hearing requests to Medicare and other insurance providers as needed for payment of client’s claims.
Collect necessary information for clients to be entered into various databases, complete client contact reports, enter data into the SHIP Tracking and Reporting System (STARS) and submit monthly reports to SHIP Coordinator on time.
Participate in community presentations, health fairs, and enrollment events and conduct SHIP related activity and outreach in the nine-county service area according to the contract with Colorado Division of Insurance. In-state travel as needed to include possible overnights.
Assist clients by assessing needs, determining eligibility, researching available options, and directing consumers to appropriate aging or disability services.
Provide appropriate referrals within the agency and to other partnering agencies.
Empower clients by providing support in decision making and planning for the future.
Assist clients to develop and implement a written care plan, when appropriate.
Conduct on-site client visits and perform a comprehensive needs assessment, evaluating the environment and safety of the home.
Network and establish cooperative relationships with community agencies and other professionals.
Participate in weekly Direct Services Team meetings and monthly in-service meetings.
Support the Direct Services team with special projects
Other duties as assigned