The Benefits Navigator is responsible for assisting clients in determining eligibility and enrolling into the Ohio AIDS Drug Assistance Program (OHDAP) and any Ryan White local and state program eligibility, preauthorization, and certification and recertification requirements through Ohio. This position is also responsible for connecting clients to Medicaid, Medicare, Qualified Health Plans through the Federal Marketplace (part of the Affordable Care Act), subsidies, and any other insurance opportunities for persons living with HIV needing health insurance services throughout Ohio. The Health Insurance Navigator is also responsible for assisting clients with any Ryan White local and state program eligibility, preauthorization, and certification and recertification requirements throughout Ohio.
This position promotes the independence, stability, and health of persons living with HIV by providing navigation services through Ending the HIV Epidemic (EHE) funding and/or through Ryan White Part B (RWB) funding. The individual will operate in accordance with the established professional standards and guidelines as stated by the Ohio Revised Code. Health Advocacy Services operate in accordance with the established professional standards and guidelines of the National Association of Social Workers (NASW) and to adhere to NASW standards for social work management.
ESSENTIAL JOB FUNCTIONS:
Essential functions of the job include, but are not limited to, knowledge of healthcare services and public and private insurances, traveling, having reliable transportation to meet clients, and utilizing a computer for typing and conducting research, attending meetings, conducting assessments, and other efforts to support successful client outcomes and graduation.
MAJOR AREAS OF RESPONSIBILITIES:
- Provide navigation and support individuals living with HIV so that they may be retained in HIV medical care and maintain viral suppression.
- Provide referrals to HIV screening programs, Linkage to Care Coordinators, Re-engagement Specialists, HIV Medical and Community-Based Mental Health providers, and Ryan White Case Managers.
- Cultivate positive working relationships with clients.
- Screen for insurance options and assist eligible clients to apply for insurance through the Federal Marketplace, as well as public insurance options, including but not limited to, Medicaid, Medicare, HIV/AIDS-specific public benefits (including the Ohio AIDS Drug Assistance Program, Ryan White Part A, Ryan White Part B) and any other public health insurance options for HIV clients/patients.
- Explain the different options available through the Federal Marketplace or public insurance, the affordability and cost-sharing structure of the plan, and the consumer rights available under these options.
- Complete all required trainings, submission of invoices, and other required duties in a timely manner and in accordance with standard operating procedures.
- Assist eligible clients in completing relevant applications, securing necessary supporting documentation, and filing the applications with the appropriate agencies.
- Acquire and maintain certification as a Federally Qualified Health Insurance Navigator
- Document and track applications and submissions.
- Advocate on behalf of the client with government offices as necessary, and identify matters that should be referred to other specialists for further action.
- Collaborate internally as a part of a cooperative and productive working environment, as well as demonstrates sensitivity, team building, support, and respect.
- Collaborate externally with all necessary community stakeholders, including but not limited to government offices and community partners.
- Participate in community outreach events, as necessary and appropriate, to support Programs and Equitas Health services.
- Participate in a minimum of 1 hour of biweekly supervision and 1 hour of group supervision per month.
- Demonstrates continuous growth and development aligned with Equitas Health Values, exhibiting an understanding, awareness, and respect for diversity, inclusion, and cultural humility.
- Utilize email, Microsoft Teams, phone, and other telecommunication options to participate in meetings across sites.
- Other duties as assigned related to this position by supervisor.
- Associate degree with a minimum of one year of relevant experience, or
- Completed coursework towards an associate degree with a minimum of two years of relevant experience, or
- Possess a high school diploma/GED with a minimum of 3 years of relevant experience
- Bachelor’s Degree in human services or related field or equivalent preferred.
Knowledge, Skills, Abilities and other Qualifications:
- Must have sensitivity to, interest in and competence in cultural differences, HIV/AIDS, minority health, sexual practices, and a demonstrated competence in working with persons of color, and gay/lesbian/bisexual/transgender
- Medical and/or Insurance related experience desired.
- Community-based services, housing services, case management services, or prevention services experience
- Proficiency in all Microsoft Office applications and general computer applications
- Must have valid Ohio driver’s license and reliable transportation.
- Must have knowledge and adherence to social work standards and ethics.
Background and reference checks will be conducted. In accordance with Equitas Health’s Drug-Free Workplace Policy, pre-employment drug testing will be administered. Hours may vary, including working some evenings and weekends based on workload. Individuals are not considered applicants until they have been asked to visit for an interview and at that time complete an application for employment. Completing the application does not guarantee employment. EOE/AA