Job Title: OUTREACH & ENROLLMENT CASE MANAGER
Supervisor: Director of Community Engagement and Enrollment
Positions Supervised: None
FLSA Status: Non-Exempt
Job Summary
This position reports to the Director of Community Engagement and Enrollment. Primary responsibility is the ongoing growth and maintenance of an optimal enrollee census. This includes, but is not limited to public awareness, education, and marketing services to providers, community partners and others. Recruits potential participants, screens for eligibility and leads the enrollment process.
Specifications
Education and Special Training: Associate’s or Bachelor’s degree or equivalent experience.
Experience: Minimum of three years of professional level experience in marketing health care products or services. One year’s experience serving the older adults. Knowledge of Medicare and Medicaid is required.
Licensure, Registry or Certification Required: Valid North Carolina driver’s license and vehicle.
Knowledge, Skills, and Abilities:
Must be able to work effectively in a team environment; Must possess excellent communication, interpersonal, public speaking and conflict resolution skills; Skilled in establishing and maintaining effective working relationships to include but not limited to colleagues, potential participants and caregivers, established participants and caregivers, colleagues, referral sources/entities, and members of the community. Knowledge of community resources available to older adults and their families. Skilled in critical thinking and problem-solving skills to ensure access. Experience in independently developing, maintaining, coordinating and carrying out promotional events, internal information programs and public information campaigns. Understanding of safety requirements relates to conducting home visits, as well as other off-site activities. Only act within the scope of his or her authority to practice; Read, write, and speak in English; Meet a standardize set of competencies for the specific position description established by PACE of the Triad and approved by the Centers for Medicare and Medicaid Services before working independently. Proficient in Microsoft programs: Word, Excel, Power Point, Teams and Access.
With or without reasonable accommodations: Ability to perform repetitive hand/wrist movements; Ability to bend and/or stoop frequently; Have independent mobility to climb stairs and walk distances. Position requires sitting and standing as associated within the scope of an administrative office environment; Ability to clearly see medical records and various documents. Communication via telephone and/or other devices as appropriate. Work conditions may change as needs
Key Responsibilities:
- Under the direction of the Director of Community Engagement and Enrollment, handles inquiries about enrolling in PACE, provides tours, education and explains the process.
- Assists with the evaluation of potential participants to identify needs and eligibility for enrollment. Includes medical record documentation and referrals to community resources.
- Schedules assessments (in the home and/or at PACE), provides PACE education and conducts tasks involved in the intake and enrollment process of potential enrollees to the program. Coordinates all level of care decisions with State Health and Human Services personnel.
- Communicates and works efficiently with the Interdisciplinary Team to evaluate potential enrollees. Schedules and/or attend meetings as appropriate.
- Completes and reviews enrollment documents/forms and submits to applicable organizations, including, but not limited to the Department of Social Services, Division of Health Benefits, NC Tracks, Medicare (MarX system).
- Serves as liaison between the local Departments of Social Services to ensure timely completion of PACE Medicaid applications, recertifications and other requests.
- Informs assigned teams and others of information about the new participants to facilitate smooth transition to PACE services and support.
- Maintain access to federal and state electronic communication systems.
- Plans and implement new participant orientation and prepare materials (ID badge, insurance card, enrollment notebook, team cards, etc.).
- Conducts weekly check-in with new enrollees within the first 30 days of enrollment and reports updates to Director of Community Engagement and Enrollment and others.
- Assists with the development, implementation and evaluation of the overall marketing strategy for the recruitment and retention of PACE participants. Conducts outbound calls, visits and presentations to meet agency goals.
- Identifies potential public relations problems and advises management team of appropriate preventative actions.
- Plans, promotes, and implements special events, meetings and education presentations.
- Assists with the production of printed publications and audio-visual productions, including the development, design and text for informational materials such as newsletters, bulletins, brochures and directories.
- Updates referral and enrollment tracking (spreadsheets/CRM), generates reports, evaluates for accuracy and trends.
- Supports PACE of the Triad’s mission, vision and values.
- Other duties as assigned.
