Health Navigator

Reports to: Insurance Navigator

Program/Department: Public Health Initiatives

Classification: Short-Term Employee

Revision Date: August 2024

SUMMARY OF POSITION:

The Health Navigator will provide critical support and help to individuals seeking health coverage through the State-based marketplace, Medicaid, and the Children s Health Insurance Program (CHIP). This role involves engaging with consumers, answering inquiries, resolving enrollment issues, and helping access to health care coverage through diverse services. The Health Navigator will help guide consumers through complex healthcare enrollment processes and ensure they are connected to the proper resources, agencies, and aid programs.

TO PERFORM THIS JOB SUCCESSFULLY, AN INDIVIDUAL MUST BE ABLE TO PERFORM EACH ESSENTIAL DUTY SATISFACTORILY. THE REQUIREMENTS BELOW REPRESENT THE REQUIRED KNOWLEDGE, SKILL, AND/OR ABILITY.

REASONABLE ACCOMMODATIONS MAY BE MADE TO ENABLE INDIVIDUALS WITH DISABILITIES TO PERFORM ESSENTIAL

FUNCTIONS.

ESSENTIAL RESPONSIBILITIES AND DELIVERABLES:

? CONSUMER ASSISTANCE: ASSIST UP TO 23,200 CONSUMERS WITH INQUIRIES ABOUT THE STATE-BASED

MARKETPLACE, INCLUDING PLAN OPTIONS, ELIGIBILITY, AND THE APPLICATION PROCESS.

? MARKETPLACE APPLICATIONS: COMPLETE AND SUBMIT UP TO 4,640 ACCURATE APPLICATIONS FOR

COVERAGE, HELPING CONSUMERS NAVIGATE THE ONLINE MARKETPLACE.

? COMPLEX CASE RESOLUTION: RESOLVE UP TO 464 COMPLEX ENROLLMENT CASES, COLLABORATING WITH

THE MARKETPLACE AND OTHER AGENCIES ON ISSUES LIKE DATA MATCHING, SEP ELIGIBILITY, AND APTC OR

CSR ASSISTANCE.

? MEDICAID/CHIP APPLICATIONS: SUBMIT 464 MEDICAID AND CHIP APPLICATIONS, HELPING CONSUMERS

DETERMINE ELIGIBILITY AND ENSURING PROMPT PROCESSING.

? REFERRALS: PROVIDE UP TO 464 REFERRALS TO AGENTS, BROKERS, AND OTHER HEALTH INSURANCE

PROGRAMS AND CONNECT CLIENTS WITH COMMUNITY RESOURCES.

? COMMUNITY ENGAGEMENT: ENGAGE WITH 23,200 INDIVIDUALS AT OUTREACH EVENTS, EDUCATING THEM

ABOUT HEALTH INSURANCE OPTIONS AND ENROLLMENT.

? PROMOTIONAL OUTREACH: TO RAISE AWARENESS ABOUT HEALTHCARE COVERAGE AND ENROLLMENT, WE

WILL REACH 92,800 INDIVIDUALS THROUGH THE SOCIAL MEDIA, RADIO, AND FLYERS.

? SERVICE AREA: SERVE AND TRAVEL WITHIN CHICAGO AND COOK COUNTY, ENSURING ACCESS TO HEALTH

INSURANCE INFORMATION AND ENROLLMENT SERVICES.

? DOCUMENTATION: COMPLETE REQUIRED DOCUMENTATION ACCURATELY AND PROMPTLY, ENSURING

COMPLIANCE WITH REGULATIONS AND CONTRACT REQUIREMENTS.

? CLERICAL TASKS: PERFORM GENERAL CLERICAL TASKS AS ASSIGNED, INCLUDING DATA ENTRY, FILING, AND

SCHEDULING.

? TRAINING AND EVENTS

? PARTICIPATE IN ONGOING TRAINING, AND STAFF DEVELOPMENT, AND ATTEND ORGANIZATIONAL MEETINGS

AND EVENTS SUCH AS THE PUERTO RICAN PEOPLE’S PARADE AND FIESTA BORICUA.

? OTHER DUTIES: PERFORM ADDITIONAL FUNCTIONS AS ASSIGNED.

This position requires compliance with all of The PRCC’s written standards, including its Standards of Conduct, all policies and procedures, and Regulatory Compliance requirements. Compliance will be considered as part of the regular performance evaluation.

SKILLS AND QUALIFICATIONS:

? A high school diploma or equivalent is needed; an associate or bachelor’s degree is preferred.

? Knowledge of the Affordable Care Act (ACA), state-based marketplaces, Medicaid, CHIP,band other health insurance programs.

? Effective communication skills to explain health insurance concepts clearly.

? Ability to work with diverse populations and engage in community outreach.

? Customer service, public health, or social services experience preferred.

? Strong organizational skills to manage a high volume of applications.

? Proficient in online application systems and health insurance enrollment platforms.

? Bilingual in English and Spanish preferred.

? Exercise tact and judgment when dealing with individuals with co-occurring disorders.

? Experience with Microsoft Office software needed.

LICENSURE:

? IL Driver’s license and access to a privately owned insured vehicle.

WORKING CONDITIONS AND PHYSICAL REQUIREMENTS:

OSHA Category equal-opportunity regular exposure to blood, body fluids, or tissues, and tasks that involve exposure to blood, body fluids, or tissues are not a condition of employment.

Job Type: Full Time

Benefits: Health, Vision, Dental, PTO

Equal Employment Opportunity Statement:

The Puerto Rican Cultural Center (PRCC) is an equal opportunity employer committed to creating a welcoming workplace that celebrates inclusion and diversity. The PRCC provides equal employment opportunity to all applicants and does not discriminate in recruiting, hiring, or promotion based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information,

pregnancy, or any other basis or characteristic protected by federal, state, or local law. In addition, The PRCC is committed to providing reasonable accommodation for qualified individuals with disabilities.