Health Advocate

GENERAL FUNCTION: Assist consumers with health insurance related issues and navigation of health insurance plans, including enrollment and navigation of Medicaid Managed Care Organizations, advise consumers of their rights, assist with complaints, grievances and appeals.

REPORTS TO: Senior Manager

RESPONSIBILITIES:

• Assist consumers with medical billing issues and
• Assist consumers with disability certification
• Assist consumers with enrolling in Medicaid Managed Care Organizations including Managed Long Term Care Plans and Mainstream Managed Care Plans.
  • Provide procedural advice and personalized recommendations to help consumers maximize their benefits under Medicaid Managed Care.
• Assist Consumers with requesting services from their plans such as:
  • Personal care services,
  • Durable medical equipment, and
  • Medical supplies.
• Inform consumers about their rights.
  • Assist with filing internal grievances and complaints to the NYS Dept. of Health.
  • Represent consumers in the external appeal to the New York State Financial Services.
• Counsel consumers with respect to joining pooled supplemental needs trusts in order to shelter income and/or resources in order to maintain Medicaid eligibility.
• Perform outreach in Westchester and Putnam Counties to promote WDOM programs and services as required by grantors.
• Performing other duties as assigned 

QUALIFICATIONS:

• 1- 3 years of experience in a related field.
• Provide individualized Medicare counseling to help consumers understand Medicare Supplement, Medicare Advantage, and Part D prescription drug plans.
• Strong verbal and writing communication
• Proficiency in Microsoft Office Suite, emphasis on Word, Excel,
• Capacity to work well independently as well as part of a team
• High-quality organizational
• Strong analytical abilities.
• Familiarity with Medicare, Medicaid, and the health care system a
• Bilingual English/Spanish is a
• Respectful of people with a disability, from different cultural and socio-economic
• MUST OWN TRANSPORTATION, HAVE VALID DRIVER'S LICENSE, INSURANCE AND THE ABILITY TO TRAVEL IN WESTCHESTER COUNTY.

Email resume and cover letters to [email protected] 

Job Type: Full Time (Non-Exempt)

Expected work schedule: Monday through Friday, 9:00 a.m. to 5:00 p.m., for a total of 35 hours per week (5 days per week).