Bilingual Enrollment and Eligibility Specialist

About St. Anthony’s

Founded in 1950, St. Anthony's is the most comprehensive safety net service center in San Francisco, directly providing food, clothing, medical care, addiction recovery services, access to technology, job training, and other critical resources to the community. Every day we support and are supported by thousands of San Franciscans. Everyone who comes through our doors joins the St. Anthony's family and helps us create a future where all people flourish.

Principal Responsibility

St. Anthony’s Medical Clinic provides primary and specialty care to individuals and families in the Tenderloin neighborhood. Our range of primary, preventative, and ancillary care supports all patients in building healthy lifestyles for themselves and their families. The Enrollment & Eligibility Specialist (EES) is a frontline member of the Community Health program at St. Anthony’s Medical Clinic (SAMC) and a liaison between the Front Desk and the rest of the clinic. The EES will generate, track, and analyze enrollment metrics and collaborate with leadership to shape SAMC’s enrollment and eligibility strategy. This position will set targets, develop and execute strategic outreach plans, and serve as the subject matter expert on enrollment. The EES may also train other frontline healthcare workers in eligibility and enrollment tasks. As a steward of healing and social justice, you are expected to meet the following duties:

Essential Duties and Responsibilities

Guest Engagement

• Explain to patients the different insurance programs (including HealthySF, Medi-Cal, MediCare, Covered CA, private-employer insurance, workers’ compensation insurance, etc.), including their eligibility requirements, relevant legal criteria, as well as applicable policies and procedures.
• Assist and coach patients on completion of applications, budgets, forms, and reports.
• Schedule enrollment and eligibility appointments in person and by telephone, text message, or MyChart message.
• Collect patient data and documents, such as income, family size, birth certificates, immigration records, public assistance documents, childcare-related documents, emergency records, medical records, etc.; accurately enters these into electronic health record (EHR).
• Review applications for accuracy, submit applications on behalf of patients, and serve as an authorized representative for benefits cases as needed.
• Educate patients on their financial responsibility for appointments at intake.
• Provide basic case management referral lists during intake appointments.
• Facilitate patients from their intake appointment to clinical intake appointment, requesting support from the team as needed.
• Link patients with other services and programs at St. Anthony’s Foundation, advocating as needed to accommodate patient needs.
• Prepare ECM referrals for patients clearly meeting qualification criteria at intake.
• Investigate and resolve issues related to patients’ insurance eligibility.
• Produces verifications of homelessness and residency; guide the creation of patient attestations.
• Coordinate transfer of patient benefit cases between counties.
• Provide external referrals to other PCPs for those patients who cannot receive care at SAMC due to their insurance situation.
• Explain the grievance process to patients and assist them in filing grievances.
• Assist patients with interpreting letters; assists clinic team with the translation of forms and develop language-accessible eligibility and enrollment documents.
• Assist patients with payment assistance program applications.
• Treat all guests with empathy, dignity, and respect. Seek to understand the other person's perspective and experience.
• Demonstrate the ability to work effectively across cultures and an openness to learning about cultures not familiar to oneself.

Program Administration and Operations

• Work and assist in planning event-based ‘eligibility & enrollment’ days at our offsite locations.
• Participate and assist in planning additional projects related to eligibility & enrollment as-needed.
• Track important insurance dates for existing patients and conducts anticipatory outreach to schedule renewal and re-enrollment appointments.
• Assist with data collection and analysis to understand our internal success rates and trends, for grant reporting, for audits & compliance, and for quality assurance.
• Enter data into the electronic health record in a timely manner.
• Collect data and information as required by the evaluation plan and processes, especially as related to client eligibility and insurance information.
• Provide feedback to evaluation team and program management on evaluation process issues.
• Maintain confidentiality in accordance with agency policy, as well as local, state, and federal laws, such as HIPAA.
• Use assigned technology to complete job functions effectively.
• Enter data and information electronically as required. Looks up data and reports electronically through a database as requested.
• Understand and follow the organization's programs, policies, and procedures
• Participate in regular training and development opportunities to increase personal capacity to apply innovative approaches to daily workflows, service delivery, and guest care and engagement.

Teamwork

• Refer patients with intensive case management needs to Community Health for ECM or other increased support; serves as a specialist resource for the team.
• Participate in Enhanced Care Management (ECM) and Community Health team meetings.
• Undergo performance reviews, including casework review, with supervisor on a regular basis; provide feedback to supervisor regarding professional development interests.
• Attend monthly meetings with SFCCC CHW Cohort for networking, training, and other professional development opportunities.
• Participate in relevant meetings supporting team communication and the program's capacity to fulfill organizational goals and mission.
• Collaboratively works with others to achieve team success.
• Manage stress and pressure situations calmly and responsively. Maintain the capacity to control reactions and awareness of how their behavior or response can impact others.
• Consistently demonstrate integrity while working and representing St. Anthony’s.
• Practice direct, respectful, open, and honest communication with their colleagues. Proactively seeks support from team members or management.
• Demonstrate cooperation with coworkers, management, and the community at large.

Minimum Qualifications

• 1 to 3 years of health plan eligibility and/or enrollment experience or sales and marketing experience in the healthcare field.
• Trained in OCHIN Epic within 3 months.
• Experience in community work, education, healthcare, or related field preferred.
• Ability to work autonomously as well as cohesively with a team.
• Excellent interpersonal, listening, oral, and written communication skills are required.
• Ability to be polite, diplomatic, and firm. Can set limits and practice professional boundaries with guests, volunteers, donors, and coworkers.

• Ability to respond to emergencies and high-pressure situations in a self-composed and self-assured manner.
• Proficient in Windows, and MS Office. Ability or willingness to learn to use information and communication technologies (computers, smartphones, and iPads) to find, evaluate, create, and communicate information.
• Ability to be punctual, reliable, cooperative, and stay team-oriented.
• Experience working in a non-profit or community-based social service agency with people experiencing homelessness or poverty desired.
• Commitment to St. Anthony Foundation Statement of Values and a desire to work for a social services agency serving the poor.

Desired Skills:

• 1 to 3 years of health plan eligibility and/or enrollment experience at a California Federally Qualified Health Center.
• Community Health Worker Certification or willingness to begin the certification process within 6 months of hire.
• Fluency in other languages, particularly Spanish, is highly desirable.
• Previously trained as a Certified Application Assistor for the Healthy San Francisco program.
• Prior experience generating, tracking, and analyzing enrollment metrics.
• Prior experience training other frontline healthcare workers in eligibility and enrollment tasks.
• Motivation to generate, track, and analyze enrollment metrics, collaborate with leadership to set targets, develop and execute strategic outreach plans, and train other frontline healthcare workers in eligibility and enrollment tasks.

Physical Demands

Work will be performed sitting at a desk/chair or standing while speaking and interacting with clients. The position will require average finger dexterity to operate normal office equipment and systems.

Sitting -   50% of the workday

Standing - 5% of the workday

Walking - 20% of the workday

Bending – 2.5% of the workday

Twisting – 2.5% of the workday

Lifting – 5.0% of the workday/Moderate, generally not over 10 pounds

Carrying - 10% of the workday/Moderate, generally not over 10 pounds

Climbing - 5% of the workday

St. Anthony’s has a diverse workforce, welcoming all ethnicities, faith backgrounds, and worldviews. We are also proudly Catholic. Our Franciscan identity is at the core of our mission, namely to uphold the dignity and value of the human person and lift the spirits of those in need to help create a society in which all person's flourish.

People of color, differently-abled people, LGBT, and folks with lived experience are strongly encouraged to apply.

St. Anthony's is proud to be an Equal Employment Opportunity Employer. We value diversity of culture, thought, and lived experiences. We seek talented, qualified individuals regardless of race, color, religion, sex, pregnancy, marital status, age, national origin or ancestry, citizenship, conviction history, uniform service membership/veteran status, physical or mental disability, protected medical conditions, genetic characteristics, sexual orientation, gender identity, gender expression regardless of physical gender, or any other consideration made unlawful by federal, state, or local laws.

St. Anthony's uses E-Verify to validate our new employees' eligibility to work legally in the United States.

Salary : $63,000