Enrollment Representative

JOB SUMMARY: Under the supervision of the Director of Redwood Coast PACE the Enrollment Representative is responsible for performing outreach and intake functions in order to increase enrollment into Redwood Coast PACE based on census goals and in compliance with State and Federal regulatory requirements.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

1. Represent Redwood Coast PACE to potential enrollees and work with healthcare partners and community organizations that can make referrals.
2. Deliver presentations and/or take part in outreach activities to inform the public about Redwood Coast PACE and to identify potential candidates for enrollment.
3. Perform all intake functions serving as a liaison and advocate for the candidate throughout the enrollment process.
4. Process and manage referrals from multiple sources.
5. Conduct enrollment process (e.g. introductory visits etc.) to determine initial eligibility and qualification of candidates for enrollment while maintaining accountability for productivity customer service and quality measures related to the enrollment processes and procedures.
6. Process the initial referral contact and talk with the prospective participant family and/or caregiver to complete an intake assessment to describe and answer questions regarding PACE eligibility and services.
7. Obtains the applicants medical records release in order to make information available to members of the Interdisciplinary Team during the initial assessment process ensuring maintenance of privacy and confidentiality at all times.
8. Collaborates with the Finance department to ensure the most current information is shared about finances financial obligation and/or how finances affect enrollment (e.g. emphasis of the private-pay financial requirements related to enrolling and remaining in the program for private-pay participants etc.).
9. Maintains accurate documentation about each prospective applicant who seeks to enroll or enrolls in Redwood Coast PACE.
10. Interfaces with the Center Manager(s) and presents enrollment candidate profile to the Interdisciplinary Team
    1. Discussion of applicants appropriateness for the program.
11. Participates as appropriate or as needed in the Interdisciplinary Teams initial assessment and care planning for participants.
12. Maintains a database of community service information.
13. Provides referral information about other community services to applicants and family or caregivers when prospective enrollees do not meet all the eligibility criteria to qualify for enrollment in Redwood Coast PACE.
14. Communicates and documents the reasons an applicant does not qualify to ensure compliance with reporting requirements. This may include correspondence with the original referral source or other appropriate entity about the outcome of the candidates enrollment process.
15. Ensures that the applicant and/or their representative remain fully apprised of all required enrollment information. Facilitates signing of all required documentation and collaborates with the Finance department and/or Administrative Assistant to ensure the completion of the enrollment process.
16. Communicates and corresponds regarding the execution of the enrollment agreement. Activities may include: sending newly enrolled participants a welcome letter to confirm enrollment; notifying the participants previous physician(s) of the participants enrollment; or notifying the referring agency of the participants acceptance and the enrollment effective date.
17. In collaboration with the PACE Outreach & Marketing Coordinator represents the PACE at various outreach activities and events. Takes part in delivering presentations and informing the public about available services to identify potential candidates for enrollment.

1. Participates in program and policy development where it concerns the enrollment component of Redwood Coast PACE.
2. Effectively collaborates with co-workers and contractors to meet Redwood Coast PACE goals and to further success.
3. Complies with all policy and procedures of Redwood Coast PACE.
4. Acts in a manner consistent with agency values.
5. Other duties as assigned.

EDUCATION &/or EXPERIENCE:

1. Bachelors Degree with emphasis in Health Services Social Services Gerontology Marketing Communication or Public Relations fields is recommended.
2. Requires three (3) or more years of experience in sales enrollment or membership recruitment and at least one (1) year working with a frail or elderly population preferably with a background in managed care and services for the elderly.
3. Previous experience in customer service is highly preferred. Knowledge of Humboldt County senior health market Medicare and Medi-Cal is desired.

LICENSES OR CERTIFICATES:

1. California Department of HealthCare Services (CDHCS) Certification as a marketing representative within one (1) month of hire.
2. Valid California Drivers License and personal auto liability insurance required.Must have a personal vehicle in good driving/operating condition insured for State minimum liability requirements that can be used for the applicable job functions noted above.
3. Current CPR and First Aid certification within six (6) months of hire.

PRE-SCREENING REQUIREMENTS:

1. Requires clearance of a DOJ and FBI criminal history background check.
2. Requires pre-employment physical and PPD skin test (TB screening).
3. Requires Motor Vehicle Report verification.
4. COVID-19 and Influenza (flu) vaccines preferred.

JOB SKILLS:

1. Customer service enrollment and/or marketing knowledge and skills necessary to work with diverse frail and/or elderly populations including sensitivity to cultural tendencies and customs.
2. Excellent interpersonal interactions that result in team building and contribute to effective work relationships successful negotiation and conflict resolution. Demonstrates effective social interaction with co-workers management participants and community contacts including referral sources.
3. Ability to work independently and within an Interdisciplinary Team and possession of strong organizational and time management skills.
4. Ability to complete duties within an agreed upon time frame and to adjust personal schedule if required adapting appropriately to changes in priorities and/or workload and incorporating an understanding of detailed requirements into action plans and implementation.
5. Demonstrates sound verbal and written communication skills to convey information effectively.
6. Maintains a positive attitude and balance in relationships with others in complex interpersonal situations. Ability to assist people who are in crisis or under extreme stress and whose primary language may not be English.
7. Ability to understand and incorporate detailed requirements in work activities. Ability to collect and analyze program data.
8. Ability to use good judgment resourcefulness flexibility and problem-solving skills.
9. Strong basic computer skills (Microsoft Outlook Word Power Point and Excel) and web-based applications such as timekeeping training and email programs.

PHYSICAL REQUIREMENTS:

1. Ability to sit at a desk and interact with a computer screen for extended periods of time.
2. Hand and arm strength sufficient to operate a keyboard for several hours each day.
3. Physical abilities sufficient to move between different staff work areas communicate with staff and the public operate a computer produce reports talk on the telephone and travel to other Agency worksites.

The above statements are intended to describe the general nature of work performed. They are not considered as an exhaustive list of all job tasks performed. Redwood Coast PACE reserves the right to change job descriptions work hours or work sites as required by the program.

The Humboldt Senior Resource Center is a private non-profit multi-purpose senior center providing a continuum of social and health related services. The agency currently holds contracts with the California Department of Aging and Area One Agency on Aging.

The Humboldt Senior Resource Center is an equal opportunity employer. We will not unlawfully discriminate against qualified applicants or employees with respect to any terms or conditions of employment based on race color national origin ancestry sex sexual orientation age religion physical or mental disability medical condition pregnancy breastfeeding gender identity marital status citizenship status military or veteran status genetic information or other basis protected by applicable federal or state law.