San Francisco Health Plan (SFHP) is the public Medi-Cal managed care plan for San Francisco serving 135,000 Medi-Cal members. SFHP also acts as a Third-Party Administrator to support the SF Department of Public Health for Healthy Kids, Healthy San Francisco and the SF City Option.
Key to our success at SFHP is the support and assistance we provide to our members and the community at our Service Center. The Enrollment Coordinator will serve a vital role in this success by serving thousands of clients each year, helping them to navigate complex health insurance rules, processes and programs
As an Enrollment Coordinator, you will gain front-line experience helping members of the San Francisco community apply and enroll in health coverage. You will learn and master the systems and applications for at least 6 health coverage programs and be able to accurately and effectively screen a client to determine the best health coverage option(s) for their family. An Enrollment Coordinator will undergo extensive training and obtain certifications in eligibility rules and application processes for Medi-Cal, CalFresh, Covered California, Healthy San Francisco, SF City Option, and the Healthy Kids programs.
The ideal candidate for this position will possess strong customer service skills, be highly organized, inquisitive and flexible in a health care enrollment environment that is constantly changing. The candidate will have demonstrated experience in following and adhering to policy and procedure, skilled in distilling or translating program rules and regulations into easily understandable and practical terms for our clients and applicants.
WHAT YOU'LL DO
- Assists potential applicants, existing members and participants with eligibility and enrollment into health coverage.
- Provides counseling and education about health insurance and health coverage options for clients and their families in a fair, accurate, impartial, and culturally sensitive manner.
- Maintains program expertise, training requirements, and certifications for all application assistance services offered by the SFHP Service Center, including Medi-Cal, Covered CA (Medi-Cal Managed Care Plan Enroller training and certification), Healthy San Francisco (HSF Application Assistor training), and Healthy Kids (HK Application Assistor training).
- Accurately determines program eligibility and documents all interactions and encounters with applicants in the appropriate system.
- Conducts outreach calls and schedules in-person appointments with potential applicants and existing SFHP members and participants renewing coverage.
WHAT YOU'LL BRING
- Bachelor’s degree or equivalent experience desired.
- Bilingual ability in Spanish or Cantonese desired.
- Exemplary interpersonal and customer service skills.
- Ability to communicate program rules and policies in clear, understandable terms accurately and professionally to various audiences and individuals of diverse backgrounds.
- Ability to comprehend, interpret and comply with complex rules and regulations, including privacy and compliance standards, program eligibility rules and processes.
- Possesses superior interviewing and communication skills to ensure applicants understand their health care coverage choices, costs or other relevant information and are screened and enrolled in the appropriate health coverage program.
- Demonstrates consistent good judgment, organization and prioritization skills, and time management skills.
- Ability to assess, escalate, think critically and prioritize cases or issues to management.
- Strong computer skills, including high proficiency in Microsoft Office (Excel, Word, Outlook, PowerPoint).
- Experience with eligibility applications such as One-e-App, CalHEERS, or mybenefitsCalWIN is desired.
San Francisco Health Plan is an Equal Opportunity Employer (EOE) M/F/D/V
Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.