Insurance Navigator

Job Responsibilities

• Conduct public education activities to raise awareness about coverage options available under Medicaid, CHIP, and the Marketplace.
• Help individuals understand, apply, and access affordable insurance options.
• Provide information and assistance in a fair, accurate, and impartial manner.
• Provide information and assistance in a manner that is culturally and linguistically appropriate to diverse communities and accessible to individuals with disabilities.
• Provide referrals to any applicable office of health insurance consumer assistance or ombudsman established under Section 2793 of the PHS Act to address consumer grievances, complaints, or questions about their health plan, coverage, or a determination.
• Demonstrate the capacity to conduct “in reach” with currently uninsured health center patients and “outreach” to non-health center patients in their approved service area. The Navigator is required to help any patient or resident seeking outreach and enrollment assistance. If the Navigator does not have the capacity to adequately help an individual due to language or other barriers, the Navigator must provide timely referrals to other resources, such as the toll-free Marketplace Call Center, or to other state or local entities that can more effectively serve that individual.
• Collaborate with other health centers and providers in the service area to ensure that outreach and enrollment assistance activities are coordinated with other local, regional, and/or state-wide outreach and enrollment assistance efforts.
• Provide approved teaching literature and educational materials to patients and their families.
• Attends meetings, seminars, and conferences as appropriate to ensure skills and knowledge remain current.
• Other duties as needed or assigned by manager(s).

Requirements

• Must successfully complete the CMS Navigator training program.
• Registration and certification as a Navigator by CMS.
• Licensed Navigator by the Missouri Department of Insurance.
• Must demonstrate and maintain expertise of eligibility and enrollment rules and procedures; the range of qualified health plan options and insurance affordability programs; the needs of underserved and vulnerable populations; and privacy and security standards.
• Knowledge of Microsoft programs with the ability to effectively communicate using Outlook.
• Experience with outreach and enrollment procedures, and of state and federal policies.
• Good interpersonal and human relations skills are required. Must possess skills to empathize and care for a variety of patients, including low-income and diverse cultures and treat everyone with respect and dignity.
• Ability to always maintain confidentiality, in all situations, and follow the laws and intent of the most current HIPAA laws and regulations as well as security and privacy policies.
• Above average computer skills to operate and/or learn application system.
• Ability to be physically active for long periods of time to ensure patient care and safety and have the ability to work well under pressure and present self in calm, caring, and professional manner.
• Frequent local and occasional statewide travel required for outreach and training.
• Medicare – CLAIM Certified.