Health Benefits Analyst II - Portuguese Speaking Required (Open & Promotional)

San Mateo County Health is seeking a well-qualified, Health Benefits Analyst II – Portuguese Speaking Required (HBA II), for the Health Coverage Unit, to perform a variety of tasks involved in determining eligibility and enrollment in healthcare financial assistance programs for families and individuals including screening and assisting with the application process for County, State and Federal health coverage programs; determine initial and continuing eligibility for one or more programs in accordance with established procedures; and coordinating and conducting outreach, enrollment, retention and utilization activities. Incumbents may be assigned to the San Mateo County Health, Health Plan of San Mateo, or San Mateo Medical Center, which includes outlying clinics in various locations throughout the County.

Currently, there is one, Regular, Full-Time position. The successful hires will work primarily at San Mateo Medical Center but may travel to various locations throughout the county and will provide public health coverage enrollment assistance to San Mateo County residents.

Health Benefits Analyst II is the journey level in the Health Benefits Analyst series. Under general supervision, incumbents are responsible for interviewing clients, assessing client financial status and determining eligibility for healthcare financial assistance programs. They are expected to have full knowledge of regulations and procedures, work with independence of action and use judgment in making decisions.

The ideal candidate will be able to work with clients to ensure eligibility for and enrollment in healthcare programs; work independently with minimal supervision using initiative and sound independent judgment; communicate effectively verbally and in writing; use Portuguese speaking skills in providing services; and establish and maintain effective working relationships with those contacted in the course of work. The ideal candidate should also have knowledge and experience in the eligibility and enrollment processes for various public health coverage programs including, providing eligibility and enrollment assistance with public health coverage programs such as Medi-Cal, Covered California and the Access and Care for Everyone (ACE) program; working experience with public health coverage application systems, client appointment and case management systems, tele-consult video appointment systems; as well as experience with automated systems related to health coverage enrollment and eligibility including the California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS) and Benefits Cal application system.

• Interview clients to obtain pertinent information regarding eligibility for healthcare financial programs.
• Assist the public with enrollment in programs to assist with medical coverage such as Medi-Cal, Covered California, Access and Care for Everyone (ACE), Discounted HealthCare (DHC), Charity Care and the Kaiser Community Health Care Program
• Provide a variety of routine to difficult patient services office support within County Health and San Mateo Medical Center.
• Serve as the initial contact for many low-income clients seeking free or low-cost insurance and will help guide them through the enrollment process.
• Provide final determination for County healthcare financial assistance programs such as the ACE, Discounted HealthCare and Charity Care programs.
• Work closely with out-stationed Human Services Agency Benefits Analysts and clinic staff in order to finalize eligibility determinations for Federal, State and County funded programs.
• Participate in policy training for all programs and all relevant refresher courses.
• Interact with staff from the community-based organizations, San Mateo Medical Center, the Health Plan of San Mateo, the Human Services Agency, and other state and local stakeholders.
• Attend assigned staff meetings.
• Participate in community outreach events.
• Administer outreach, navigation, utilization and retention activities in regard to healthcare programs to ensure families understand program benefits and that covered services are being accessed.
• Other duties as assigned.

Qualifications

Education and Experience:
Any combination of education and experience that would likely provide the required knowledge, skills and abilities is qualifying. A typical way to qualify is:

• Health Benefits Analyst II: One year of experience performing assessment, placement and/or healthcare financial assistance eligibility work within the last five years.

• Public and community resources and programs.
• The interrelationships of the various disciplines in the health and human services field.
• Interviewing techniques.
• County, State and Federal healthcare financial assistance program policies and regulations.
• Office procedures and practices, including filing and the operation of standard office equipment.
• Basic record keeping principles and practices.
• Automated systems.
• Workload planning and prioritizing techniques.

• Organize and maintain a heavy workload on a current basis and within set deadlines.
• Follow instructions.
• Communicate effectively, orally and in writing with people of diverse backgrounds and cultures.
• Establish and maintain effective working relationships with those contacted in the course of the work.
• Work well under pressure.
• Work in accordance with the established guidelines.
• Make independent decisions.
• Assume responsibility for assigned tasks.
• Deal effectively with divergent needs of customers.
• Interpret and apply laws, rules and regulations.
• Prepare, maintain and interpret reports and records.

Application/Examination

Open & Promotional. Anyone may apply. Current County of San Mateo and County of San Mateo Superior Court of California employees with at least six months (1040 hours) of continuous service in a classified regular, probationary, extra-help/limited term positions prior to the final filing date will receive five points added to their final passing score on this examination.