Health Insurance Navigators, Health Federation of Philadelphia

Posted by on September 09, 2013

Health Insurance Navigators, Health Federation of Philadelphia
Posted on: August 27, 2013

Job description
To facilitate consumer enrollment in a Qualified Health Plan (QHP) through the Federal Marketplace and/or other health programs such as Medicaid and CHIP by providing fair, impartial, and accurate information that assists consumers with submitting the eligibility applications, clarifying distinctions among QHP’s, and helping qualified individuals make informed decisions during the health plan selection. The Navigator will conduct consumer assistance activities as well as outreach and education activities to consumers and businesses about the availability of these programs and insurance affordability to encourage participation. The Navigator will provide all services for the public good and serve as a resource to all consumers, including but not limited to, existing patients of the health center as well as to consumers, particularly from communities that are under-served by and under-represented in the current health insurance market.

These positions are currently funded for one year. While intended as full time with benefits, individuals interested in pursuing as a part-time position should submit an application for consideration with an explanation of their availability and situation.

Principal Accountabilities/Responsibilities

1. Provide application assistance and facilitate enrollment of eligible patients and community members in health insurance programs.

2. Maintain knowledge and expertise in eligibility, enrollment, and program specifications of the Federal Marketplace and other health coverage programs such as Medicaid and CHIP.

3. Implement outreach strategies to promote the availability of health insurance and encourage participation of consumers particularly in communities that are under-served and under-represented in the current health insurance market.

4. Conduct outreach and education activities to educate health center patients, consumers, businesses, community organizations and other stakeholders about insurance affordability through the Marketplace, Medicaid and or CHIP to encourage participation.

5. Provide information and assistance in the consumer’s preferred language and or provide limited-English proficiency consumers with oral and written notices of their rights to receive language assistance services and how to obtain such services.

6. Provide referrals for consumers with questions, complaints, or grievances to any applicable office of health insurance consumer assistance or health insurance ombudsman, or any other appropriate state agency or agencies.

7. Ensure the protection and security of a consumer’s personal, confidential and identifiable information in a professional and responsible manner and carry out all measures to prevent from unauthorized disclosures.

8. Demonstrate and maintain the standards and requirements of the Health Insurance Portability and Accountability Act (HIPAA).

9. Operate effectively as a member of a team of Navigators based at the Health Federation of Philadelphia

10. Participate in monthly conference calls and regularly scheduled meetings with the Navigator Project Management team at the Pennsylvania Association of Community Health Centers (PACHC) and provide updates to discuss issues, best practices, and modifications or challenges with the federal application and/or online application for Medicaid and CHIP.

11. Build new relationships and maintain existing ones with current and future community entities that are providing services to consumers to promote health insurance coverage through the Federal Marketplace, Medicaid, and or CHIP.

12. Participate in CMS and other required training for Navigator certification and to enhance outreach and enrollment expertise.

13. Provide data and other information necessary for CMS and other reporting requirements.

14. Assist with the development and dissemination of marketing and promotional materials for outreach, application assistance and education activities that are tailored to the health center service delivery area and target population

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