About us
Ponos Care specializes in providing compassionate value-based care through a physician-driven, home model. Our comprehensive approach integrates social, mental, physical, and economic solutions, addressing the unique needs of patients with chronic conditions such as sickle cell disease, ulcerative colitis, Crohn's disease, and severe rheumatoid arthritis. Our mission is to reduce emergency room visits and improve the quality of life for our patients through comprehensive, coordinated and effective care.
We are hiring an experienced Eligibility Specialist to join our team, this role advocates for our members access to appropriate resources with a strong commitment to helping patients navigate equal access within their healthcare needs.
This role involves identifying and initiate referrals/ applications for social service programs; including financial, psychosocial, community and state supportive services, and manage the care plan throughout the continuum of care as a single point of contact for our members. This role reports to the Eligibility Program Manager.
RESPONSIBILITIES:
- Acts as liaison role with our members to ensure appropriate care is accessed as well as to provide home and social assessments and member education. The coordinator also addresses social determinant of health such as transportation, housing, and food access.
- Utilize both organization and community-based resources to establish a safe and effective case management plan for members.
- Collaborate, education and communicate with member, family, and healthcare providers.
- Identify and initiate referrals for social service programs, including financial, psychosocial, community, and state supportive services. Including assisting the Member with all aspects of the eligibility determination process and coordinate with the local Department of Social Services.
- Communicate with all stakeholders the required health-related information to ensure quality coordinated care and services are provided expeditiously to all members.
- Advocate for patients and families as needed to ensure the patient's needs and choices are fully represented and supported by the healthcare team.
- Adhere to detailed, specific documentation requirements in the member’s health record.
- Works in partnership with members to educate and apply for SSI on member behalf, manages state application, tracks eligibility and updates members appropriately in eligibility status.
- Provide member education on community and state resources, benefits and assess eligibility for state programs including TANF, CCC+, SSI and applicable state programs.
QUALIFICATIONS:
- Bachelor's in relevant human services field of study preferred, High School Diploma required
- 1+ year of relevant work experience in various federal, state and local public assistance and benefit programs or services programs; Previous experience in a call center or customer service role, preferably in a healthcare setting navigating state health & human services benefits application process.
- Strong experience in state of Virginia health & human services application process (Medicaid, CCC+, TANF, SSI).
- Excellent communication skills, both verbal and written.
- Strong organizational and multitasking abilities.
- Proficient in using electronic health records (EHR) and other relevant software.
- Compassionate and patient-focused with a strong commitment to providing high-quality service.
- Ability to work independently and effectively, within a remote setting.
- Bilingual skills are a plus.
The ideal candidate will have a strong background in VA state welfare and benefit experience (Department of Health or equivalent setting experience is a plus).
SALARY RANGE: $25-$28/ per hour, this is a Full Time, Remote position.
Job Type: Full-time
Pay: $25.00 - $28.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee discount
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: Hybrid remote in Richmond, VA 23226
