Enrollment Specialist
- Supervised by: Director of Marketing
- Supervises: None
Job Summary:
Under the supervision of the Director of Marketing, the Enrollment Specialist helps prospective participants navigate the enrollment process with the goal of helping each obtain enrollment. The Enrollment Specialist coordinates the enrollment process, collaborates with external stakeholders such as Medicaid, assists prospective participants to obtain Medicaid eligibility, and collaborates with staff internally. The Enrollment Specialist provides information and referrals to community agencies as appropriate, as well as promotes [Asian Heritage Healthcare] in the community to prospective participants, community agencies and more.
Qualifications and Requirements:
Education:
- High School Diploma or GED required.
- Associates or Bachelor’s degree in health-related field preferred.
- Education or training in geriatrics preferred.
Experience:
- Minimum 2 years of experience in an outreach/marketing, intake or sales role in a health care setting.
- Minimum of 4 years’ experience if no degree.
Skills and Knowledge:
- Ability to effectively present PACE philosophy and model to the community and to prospective participants.
- Working knowledge of physical, psychosocial, behavioral and family needs of the elderly.
- Working knowledge of community health and social service delivery systems and aging networks.
- General knowledge of financing mechanisms such as Medicaid & Medicare.
- Good working knowledge of PACE philosophy and eligibility/denial criteria.
- Excellent written and verbal communication skills.
- • Computer proficiency in Microsoft Word, Microsoft, Excel, and Microsoft Outlook.
- Strong organizational and time management skills with the ability to schedule appointments.
- Able to work independently and function with minimal supervision.
Physical Demands and Working Conditions:
The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. In compliance with ADA requirements, reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
Work Environment:
Employee must be able to work effectively within an interdisciplinary team model, interfacing and collaborating with a wide range of clinical and social services disciplines who work together to manage the PACE participants’ care. The work setting is in an Adult Day Health Center and primary care clinic environment with moderate noise levels and controlled temperatures.
Physical Requirements:
Requires corrected vision and hearing to normal range. Must be able to communicate with all staff, vendors, and clients. Requires manual and finger dexterity and eye-hand coordination; the ability to use department equipment. Requires lifting/carrying up to 65lbs.and pushing or pulling 150lbs.using appropriate body mechanics and equipment, with reasonable accommodation if needed.
Visual, Hearing and Communication Requirements:
Requires corrected vision and hearing to normal range, with or without reasonable accommodation. Ability to communicate by way of the telephone with participants, customers, vendors and staff.
Pressure Factor:
Requires working under stressful conditions. Working conditions may be noisy and crowded and fluctuating indoor temperatures. Moderate pressure to meet scheduled deadlines. Potential for exposure to verbal aggression by client, vendors, and staff.
Environmental Conditions:
May be exposed to a risk of bodily injury through contact with moving instrumentation, toxic substances, medicinal preparations, bodily fluids, communicable diseases and any other conditions common in a healthcare environment. Subject to unpleasant odors.
Duties and Responsibilities:
Receives and provides information to referrals to the PACE Program; refers individuals to other appropriate resources as indicated.
Accepts referrals and inputs appropriate information into appropriate tracking methodology(s) and EHR timely.
Maintains current, written assessment and intake records inclusive of potential participant’s expressed wishes and the referral services provided, as appropriate.
Provides information on eligibility for the PACE program to both the participant and caregivers (if applicable).
Assesses prospective PACE participants in homes, nursing homes, hospitals or other settings as part of the intake process.
Communicates timelines and deadlines for assessments and prospective participant enrollment status within the marketing and enrollment department, with PACE program leadership and the IDT.
Participates in Interdisciplinary Team meetings when potential enrollees are assessed for enrollment into the program for purposes of providing and clarifying information obtained during the enrollment process.
Assists with financial eligibility process for potential PACE participants by reviewing Medicaid eligibility and facilitating Medicaid applications with necessary supporting documentation for approval.
Ensures necessary paperwork related to participant enrollment is received by [State of X] and [X Medical Records Staff] on or before the appointed cut-off date. •
Assists with community engagement and marketing activities as directed by Marketing and Enrollment Manager or other marketing staff. •
Collects data and prepares reports in accordance with the State PACE Administering agency and CMS requirements. • Assists in evaluating the intake and assessment process, identifying problem areas accordingly and making changes as recommended. •
Contacts identified key referral sources regularly to discuss possible program participants. •
Maintains ongoing relationship with identified individuals and agencies to ensure a clear understanding of PACE as a vital community resource. •
Shares responsibility with other team members in the implementation of the PACE philosophy and achievement of program goals. •
Participates in process and quality improvement initiatives.
General Responsibilities:
Attends staff meetings and in-service training as required.
Follows all Policies and Procedures and Occupational Safety and Health Administration (OSHA) safety guidelines.
Protects privacy and maintains confidentiality of all company procedures, results and information about employees, participants and families.
Practices Universal precautions and follows appropriate Infection Control procedures.
Maintains safe working environment.
Participates in and supports the Quality Improvement initiatives.
Participates in continuing education classes and any required staff and training meetings.
Maintains professional affiliations and any required certifications.
Performs other duties as required or requested.