Medical Benefits Manager The AIDS Foundation of Chicago (AFC) mobilizes communities to create equity and justice for people living with and vulnerable to HIV and related chronic diseases. We envision a world in which people living with HIV and related chronic diseases will thrive, and new HIV infections will be rare. Our work focuses on improving health equity, preventing new cases of HIV, serving as a collaboration and knowledge center, and being a bold voice for change. We are seeking for an individual to serve as our Medical Benefits Manager. The Medical Benefits Manager is responsible for enrolling eligible Illinoisans receiving Ryan White services in the Cook and Collar Counties, into qualified health plans through the Illinois Health Marketplace, insurance companies, Medicaid, Medicare as well as providing assistance with ADAP/MAP benefits. The Medical Benefits Manager will be required to complete up to 30 hours of training to obtain consumer assistance certification and will be required to recertify on an annual basis at the federal and state level. The Medical Benefits Manager will also be required to facilitate trainings/educational forums throughout Cook and Collar counties as well as implement new peer outreach programs to increase the reach to uninsured individuals. The Medical Benefits Manager will be required to build relationships with managed care organizations in order to assist clients in navigating their insurance benefits. Principal functions and responsibilities of this position include the following: Client Work - Manage efforts with Ryan White-funded agencies to identify individuals to be enrolled in health insurance programs;
- Screen clients for eligibility for Medicaid, Medicare, Health Insurance Marketplace (HIM) and ADAP/MAP;
- Assist individuals in understanding HIM plans, managed care options for which they are eligible and navigating ADAP/MAP applications;
- Enroll clients in the appropriate insurance plan they select;
- Demonstrate cultural competency when working with clients who may be HIV+, LGBT, homeless, indigent, substance users, mentally ill, non-English speaking, or otherwise marginalized and/or underserved;
- Adhere to the standards and requirements of the Health Insurance Portability and Accountability Act (HIPAA);
- File appeals on behalf of clients with the Illinois Department of Insurance, the Health Insurance Marketplace, or private insurers;
- Assess and vet insurance plans;
- Document all client level activities in the Provide database.
Training and Reporting - Maintain knowledge and expertise by attend trainings and continuing education related to insurance programs as required by AFC including the case management competencies training;
- Design and conduct training modules for case managers and client regarding Marketplace, Medicaid and or CHIP (Continuous Health Insurance Plans) in Cook and Collar Regions;
- Conduct Provide database trainings on insurance as needed;
- Function as a resource to case managers and consumers by providing information, assistance and referrals, and taking complaints, or grievances to any applicable office of health insurance consumer assistance or health insurance ombudsman, or any other appropriate state agency or agencies;
Outreach - Assist in managing the implementation of Medical Benefits Management programs within AFC, including creating documents that can be disseminated within the community;
- Present data on enrollment work to the contract administrators as well as the Collar Counties Advisory Board.
Staff Supervision - Hire, train, mentor and supervise assigned staff; including assisting with recruitment; selection; scheduling and job assignments, mentoring/coaching; staff development and training; performance evaluation; and recommending salary, disciplinary and other personnel actions in accord with personnel procedures.
- Provide professional development opportunities and guidance to each team member to strengthen their skill sets and job satisfaction; meet regularly with assigned staff to identify priorities, discuss strategies, and review ongoing projects.
Other - Assist with agency-wide activities as directed, including Annual Meeting, AIDS Run & Walk, World of Chocolate and others.
- Attend and actively participate in required, All staff, Care Team meetings.
- Update job knowledge by participating in educational opportunities; reading professional publications; maintaining personal networks; participating in Team for Health Literacy quarterly meetings.
- Protect organization's value and manage risk by keeping information confidential.
- Perform other duties as assigned by supervisor.
QUALIFICATIONS Minimum Qualifications High School Diploma or GED and 2 years or more years’ experience in the Human Services Field. 2 years or more supervisory experience. The ability to work non-traditional hours, including evening and weekend hours. Preferred Qualifications Bachelor’s degree in the Human Services field. 1 year or more Case management and/or public benefit screening experience State of IL Certified Insurance Application Counselor Knowledge, Skills, and Abilities Strong attention to detail and the ability to manage multiple projects, establish workload priorities, and meet deadlines are critical. Excellent customer service skills and strong interpersonal skills and the ability to develop and maintain professional, trusting and positive working relationships with both internal and external customers. Also, strong verbal and written communication skills and ability to work with diverse populations are key to success in this role. To Apply, Please click on the link below. http://ejob.bz/ATS/jb.do?reqGK=27127421&portalGK=7853 Please reference position code PROG MBM 309 Decisions and criteria governing the employment relationship with all employees at AIDS Foundation of Chicago are made in a non-discriminatory manner, without regard to race, ethnicity, creed, religion, color, sex, sexual orientation, gender identity or expression, age, national origin, citizenship status, military service and/or marital status, order of protection status, handicap, disability (including HIV/AIDS status), or any other factor determined to be unlawful by federal, state, or local statutes. |
