The Sisters of the Holy Names of Jesus and Mary is a congregation of Catholic Sisters and Associates who are dedicated to the full development of the human person through education, social justice, contemplation and the arts.
The Oregon Transportation and Benefits Coordinator has primary responsibility for the medical appointment calendar for the Oregon Sisters, communicating with Health & Well-Being (H&WB) staff, physicians and other providers to ensure timely and safe rides to appointments, accompanying Sisters to appointments as needed. Responsibilities also include ensuring that all Oregon Sisters of the Holy Names of Jesus and Mary (SNJMs or Sisters) receive appropriate health insurance and public benefits based on their individual needs, circumstances, and SNJM Health & Well-Being Office guidelines. This position directly assists Sisters in accessing benefits and is responsible for maintaining current and accurate benefits information in paper and electronic files following Province guidelines. Oregon Transportation Coordinator duties are approximately 80% of a 40-hour work week, with Oregon Benefits Coordinator duties accounting for the remaining 20%.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
- Assists with scheduling care coordination visits, and with obtaining equipment, supplies, and specialty items needed by Sisters. Arranges for timely and safe rides for Sisters to attend appointments. As necessary, in close collaboration with the Oregon Care Coordination Team, and under the direction of the H&WB Manager of Healthcare Services, accompanies Sisters to appointments as needed.
- Meets with Sisters in their residences or in the Health and Well-Being office to assess individual Sister’s benefits and insurance coverage needs, in close collaboration with the Oregon Care Coordination Team, and under the direction of the H&WB Manager of Healthcare Services.
- Compares how benefits complement each other to meet specific needs of each individual Sister’s situation and recommends benefits tailored to their needs, circumstances and specific benefit eligibility. Explains to the Sister all relevant requirements and expectations for the Sister’s compliance with those requirements.
- Assists Sisters in accessing benefits, which may include arranging appointments or making telephone calls to agencies. Under the direction of the H&WB Manager of Healthcare Services, may accompany a Sister to appointments to access public benefits.
- Completes applications and recertifications for Social Security, Medicare, SSI, Medicaid and Medicare Savings Programs for eligible individuals according to application rules and deadlines. Completes enrollment applications for Medicare Advantage health plans, Medicare Supplemental plans, and other health, dental and prescription plans as needed. Assists Sisters with participation in Medicare Part D by assisting with choices of PDPs and completing applications for the Limited Income Subsidy (LIS).
- Educates Sisters, and is available to answer their questions, regarding benefit eligibility requirements, coverage, billing statements and claim status. Advocates as necessary to ensure benefits are received in accordance with the benefit plan or public program.
- Proactively keeps the H&WB Manager informed of patterns and trends observed in day to day benefits issues specific to Oregon to maximize appropriate use of benefits and minimize costs. Consults with H&WB Manager on complicated benefit questions and benefit matters involving more than an individual situation. Reports situations in which benefit eligibility requirements have come into question and seeks assistance from the H&WB Manager in appropriately resolving these situations.
- Tracks benefit applications, eligibility determinations, redeterminations, ineligibility issues, and benefit terminations by speaking with Sisters and monitoring changes in programs. Maintains complete and current records of each Sister’s health insurance and public benefits. Enters benefit information for each Sister into the Benefit Records of the Province database in a timely manner. Maintains confidential records of benefit information in paper files. Mails necessary forms and other documents in order to comply with application deadlines and procure necessary information for benefit eligibility. Notifies insurers and benefit providers upon a Sister’s death.
- Reviews benefit related bills and, as needed, resolves related problems to ensure insurance and public benefits have paid for all covered medical care, prescription, DME and related services. Seeks consultation from the H&WB Manager for unusual or new areas of expense. Forwards requests for expenses not covered by insurance or public benefits to the Manager for payment from Province funds.
- Other related duties as identified or assigned.
Works in close collaboration with: Oregon Health and Well-Being Team, Sister Services, Province Health and Well-Being Department, Sisters, and Mary’s Woods’ staff; durable medical equipment (DME) providers, physician/provider offices, and other health and well-being providers; and with county, state and federal agencies, such as Oregon Department of Human Services, Social Security Administration and Centers for Medicare & Medicaid Services, and others as needed.
QUALIFICATIONS: To perform this job successfully, individuals must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Bachelor’s degree, or a combination of post-secondary education and experience that will enable the employee to successfully fulfill the responsibilities of the position.
Minimum of 2 years’ experience coordinating Medicare/Medicaid or other public benefits and health insurance for persons over 65 and one to two years’ experience in healthcare environment.
KNOWLEDGE, SKILLS AND ABILITIES REQUIRED:
PHYSICAL DEMANDS AND WORK ENVIRONMENT:
- Must be supportive of the mission of the Sisters of the Holy Names of Jesus and Mary.
- Must model SNJM Guiding Values in carrying out work activities and responsibilities.
- Must respect and maintain confidentiality of sensitive information.
- Understanding of, and ability to maintain, appropriate professional boundaries.
- Ability to work independently and also as part of a team, to analyze and prioritize work assignments, and to execute tasks in a timely manner. Proven attention to detail and a high degree of accuracy.
- Ability to learn new and complex information about social, health and income benefits, and public entitlements. Knowledge of medical terminology.
- Ability to complete handwritten and online applications for benefit eligibility determination. Must be able to read/comprehend cursive handwriting.
- Demonstrated ability to communicate professionally, empathetically, and compassionately with elder population who may be ill, disabled, hospitalized, and/or experiencing loss.
- Ability to maintain collaborative, professional relationships with SNJM Sisters, staff, and external contacts.
- High degree of flexibility and adaptability to shifting priorities and time constraints.
- Proficient knowledge of Microsoft Office 2010 and other computer software programs including, but not limited to, Word, Excel, Outlook, and Internet Explorer. Experience with electronic record keeping systems required.
- Demonstrated written and verbal skills to assure effective communication.
- Demonstrated ability to provide excellent customer service while also maintaining HIPAA compliance.
- Ability to respond to emergencies appropriately and calmly as needed.
- Valid driver’s license.
Performs primarily sedentary work in office/residential facility setting. Occasional travel to Sisters’ homes or accompaniment of Sisters to benefit or other appointments is required. Occasional travel to trainings and meetings outside of local area.
Full-time, 40 hours per week (approximately 32 hours per week for transportation coordination and 8 hours per week providing Oregon benefits coordination).
Personal computer, keyboard, mouse; office telephone/voice mail system; and web conferencing equipment.
The above description generally reflects the primary functions of the position. The above statements shall not be construed as a detailed description of all the work requirements that may be required for the position.
: In order to be considered an applicant for this position, please complete our online employment application at https://snjm.catsone.com/careers
. Click “Apply Now” to complete and submit the online application.
SNJM is committed to continually building a workplace that exemplifies its values and vision of being hospitable to everyone. The Sisters of the Holy Names of Jesus and Mary (SNJM) is an Equal Opportunity Employer.
We offer a competitive salary and benefits package including medical/dental, group life and disability coverage, a 401K plan, and paid time off.
To learn more about the mission and vision of the Sisters of the Holy Names visit: www.snjmusontario.org