Duties and Responsibilities:

Patient Navigation and Care Coordination:

• Conveys the purpose of programs and services to patients and explains how they impact health outcomes and access to care.
• Assists patients in understanding plans of care, medications, self-management activities, and provider instructions.
• Helps patients develop individualized health management plans and goals through assessment of patient needs.
• Follows up on health management plans and goals with patients and providers.
• Assists individuals with self-management of chronic health conditions and medication adherence.
• Identifies patients at risk for poor adherence and implements appropriate engagement strategies.
• Assists patients in accessing healthcare services and overcoming barriers related to medical care, transportation, insurance coverage, and social determinants of health.
• Facilitates communication and coordination among patients, providers, care teams, and community organizations.
• Acts as a patient advocate and liaison across all disciplines and services.

Health Insurance Enrollment and Benefits Navigation:

• Provides application assistance and facilitates enrollment of eligible patients and community members in health insurance programs.
• Maintains expertise in eligibility requirements, enrollment rules, and program specifications for the Federal Marketplace, Medicaid, CHIP, SFA, and other available healthcare coverage programs.
• Assists individuals with assessing program affordability, eligibility requirements, and enrollment options.
• Provides accurate, unbiased, and impartial information to help consumers make informed decisions regarding health coverage and plan selection.
• Assists patients with Marketplace applications, Medicaid/CHIP/ enrollment, renewals, appeals, and coverage-related questions.
• Provides referrals to consumer assistance programs, ombudsman services, or other state agencies as appropriate.
• Ensures timely escalation of enrollment issues and communicates solutions, best practices, and lessons learned to leadership.

Community Outreach and Education:

• Participates in patient and community outreach initiatives to improve access to care, health coverage, and available resources.
• Maintains flexibility to work occasional evenings, weekends, and non-traditional hours to support community engagement, Mobile Health Unit operations, and organizational initiatives.
• Represents Tandem Health professionally at community events and activities designed to promote awareness of services and improve access to care.
• Plans, implements, and participates in advocacy, education, enrollment, and outreach activities sponsored by Tandem Health and community partners.
• Conducts targeted public education activities to increase awareness of healthcare services, health insurance options, and community resources.
• Builds and maintains relationships with community organizations, service providers, agencies, and stakeholders to strengthen referral networks and improve patient access to services.
• Continuously expands knowledge of community resources, services, programs, and benefits available both within Tandem Health and throughout the community.
• Conducts intake assessments, health education sessions, and health maintenance activities in the patient's home, clinic, community setting, or via telephone as appropriate.
• Motivates patients to become active and engaged participants in their health and healthcare decisions.

Patient Advocacy and Cultural Responsiveness:

• Provides culturally and linguistically appropriate services to patients and families.
• Works effectively with individuals from diverse cultural, socioeconomic, and linguistic backgrounds.
• Understands and responds to complex medical, social, cultural, and environmental challenges experienced by underserved populations.
• Ensures accessibility of services and resources for individuals with disabilities and limited English proficiency.
• Provides language assistance services directly or coordinates access to interpretation and translation resources as needed.
• Facilitates problem-solving related to patient concerns, complaints, questions, and service barriers.

Mobile Health Unit Support:

• Supports Mobile Health Unit operations by assisting with setup, breakdown, and preparation of equipment and supplies for community-based clinics and outreach events.
• Operates the Mobile Health Unit vehicle in accordance with organizational policies and safety standards.
• Registers patients and verifies demographic, insurance, and eligibility information.
• Collects copayments and assists patients with required forms, consents, and other registration documentation.
• Coordinates patient flow to ensure efficient clinic operations.
• Assists clinical staff with non-clinical operational needs to support patient care delivery.
• Promotes Mobile Health Unit services through community outreach activities and assists with expanding access to care in underserved areas.
• Ensures compliance with organizational policies, patient confidentiality requirements, and safety procedures during Mobile Health Unit operations

Documentation, Reporting, and Compliance:

• Collects, tracks, enters, and reports data required for program evaluation, grant reporting, CMS reporting, and organizational performance measures.
• Maintains accurate documentation of patient interactions, outreach activities, referrals, and outcomes.
• Provides reports and updates regarding program performance, patient outcomes, and operational needs.
• Protects confidential patient information and complies with HIPAA, PII, PHI, organizational policies, and applicable state and federal regulations.
• Maintains required certifications and complies with all federal, state, grant, and organizational requirements, including conflict-of-interest standards.
• Maintains follow-up on applications submitted, follows up with patients as needed, and remains accessible to patients for ongoing support.

Professional Responsibilities:

• Builds and maintains positive working relationships with patients, providers, care managers, community agencies, supervisors, and staff.
• Works collaboratively and effectively within interdisciplinary teams while also functioning independently.
• Participates in staff meetings, conferences, trainings, certification activities, and professional development opportunities.
• Models excellent customer service by interacting with all internal and external customers respectfully and professionally.
• Responds to telephone calls, messages, and inquiries promptly and courteously.
• Promotes a calm, effective, and professional work environment.
• Performs other duties as assigned.

Qualifications:

Education/Experience:

• Bachelor's degree in a health-related field preferred, including health education, health promotion, social work, psychology, sociology, public health, or a related discipline; OR
• Associate degree and two (2) years of related healthcare, community outreach, enrollment, or care coordination experience; OR
• High School Diploma/GED and four (4) years of related experience.
• Equivalent combinations of education and experience will be considered.
• Community Health Worker certification in accordance with South Carolina requirements preferred.
• Experience with health insurance enrollment, benefits navigation, community outreach, care coordination, or patient advocacy preferred.
• Bilingual English/Spanish proficiency preferred.
• Valid South Carolina driver's license and ability to travel independently required.