Certified Navigator

Description

The Certified Navigator has three main responsibilities: 1) assisting consumers with enrollment in Maryland Health Connection in-person at HCAM locations or at partner sites; 2) participating in outreach to the community, including outreach and enrollment events, speaking events, educational workshops, meetings with partner agencies, and home visits; and, 3) assisting consumers over the phone at HCAM’s Call Center.

The primary responsibilities for this position are:

• Participate in training and successfully pass certification to be a Certified Navigator (required for continued employment)
• Participate in continuing education training sessions and certification maintenance
• Understand eligibility requirements for Medicaid programs and Qualified Health Plans (QHPs) and enroll consumers into appropriate coverage
• Work directly with clients face-to-face, over the phone, or via email to resolve enrollment questions and concerns
• Distribute information about the individual health insurance exchange, including eligibility requirements for applicable federal premium subsidies, cost sharing assistance and state medical assistance
• Provide information about Medicaid Managed Care Organizations (MCOs)
• Assist consumers with application, enrollment, renewal, and special enrollment period processes for QHPs
• Provide information on participating insurance carriers and plans in the marketplace and assist consumers with plan selection
• Understand insurance terminology and educate consumers on health insurance literacy
• Provide information to clients about verifications, document submission and applicable deadlines
• Provide referrals to appropriate agencies, including the Attorney General’s Health Education and Advocacy Unit (HEAU) and the Maryland Insurance Administration (MIA), for applicants and enrollees with grievances, complaints, questions or the need for other social services
• Provide all information and services in a manner that is culturally and linguistically appropriate and ensures accessibility for individuals with disabilities or impairments
• Participate in enrollment and outreach events
• Administrative duties related to documenting consumer information and data collection
• Escalate cases to Team Lead or Training and Quality Assurance specialists when appropriate
• Work closely with HCAM’s other programs to ensure comprehensive services to all consumers
• As assigned, answer calls and address consumer questions at the HCAM Call Center
• Other Duties as Assigned

Qualifications

• High School Diploma or GED required, college degree preferred
• Excellent organizational skills
• Proven ability to meet deadlines
• Ability to effectively engage clients and connect them to resources
• Ability to comprehend and manage documentation in multiple databases
• Ability to problem solve
• Demonstrated initiative in approaching complex cases
• Proficient in MS Word, Excel, and Outlook
• Positive attitude in work duties and interactions with peers, clients and partners
• Ability to communicate well in writing, via phone, and face-to-face with professionals and clients
• Excellent customer service skills and ability to remain calm under pressure
• Ability to work in remote locations with little supervision in both Frederick and Carroll Counties
• Access to reliable transportation and ability to travel throughout the region
• Ability to work non-traditional hours, some evening and weekend hours required
• During our busy season (November 1- December 15) use of Paid Time Off will not be granted in order to meet staffing needs at all locations.

PHYSICAL REQUIREMENTS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk, hear and respond to customers and employees. The employee frequently is required to stand; use hands to finger, handle, or feel; reach with hands and arms; climb or balance; and stoop, kneel, crouch, or crawl. The employee is occasionally required to walk and sit. The employee must regularly lift and/or move up to 25 pounds and occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.

SAFETY & HEALTH RESPONSIBILITIES

HCAM is committed to providing and maintaining a safe, secure and healthy work environment for all employees, clients served, volunteers and visitors. As part of this commitment, HCAM has developed safety, security and occupational health policies, practices, and standards.

With this understanding, all employees are required to: Adhere to all local, state and federal safety and environmental codes, ordinances, standards and laws; adhere to all HCAM and local safety plans, policies, practices and standards; be aware of and follow all safety rules of your work site; report any unsafe conditions or accidents to your supervisor; practice standard precautions (formerly universal precautions) at all times, and; participate in mandatory or available safety training.

WORK ENVIRONMENT

While performing the duties of this job, the employee is exposed to both indoor and outdoor conditions. The employee will be subject to noise.

OUR CULTURE 

HCAM is dedicated to fostering diversity, equity, and inclusion in our commitment to support our employees and the Marylanders we serve.

HCAM's DEI Vision Statement: “To be regarded as a leader in equitable access to health care through policy and practices, and a workplace whose culture promotes diversity, values its team, and fosters inclusion.”