The Coverage Case Manager is a professional, social services position that effectively manages and navigates the MaineCare and Health Insurance Marketplace application processes and enrollments on behalf of uninsured and underinsured individuals. Connecting directly with clients to identify their eligibility for coverage programs and serves as the primary advocate for clients in all stages of the enrollment or re-enrollment process.
Responsibilities include, daily collaboration with various departments, including the Central Billing Office, to coordinate payment for care, facilitate the exchange of necessary forms and information for the client, and connect clients to other community resources as needed. Provide information about the CarePartners/MedAccess programs to callers and walk in inquiries and does initial eligibility screening via telephone and/or in person, schedules applicants for comprehensive CarePartners/MedAccess intake and enrollment services, or other health related services and referrals as needed and appropriate.
Become a Certified Application Counselor (CAC)
The Coverage Case Manager assists with other tasks related to enrollment, re enrollment, prescription assistance, case management, and other projects as assigned by the Program Coordinator to ensure members can access care as necessary. Provides in depth research and information for programs such as PAP, and other available community resources.
This position is located at the Sanford, ME campus of Southern Maine Health Care.
Required Minimum Knowledge, Skills, and Abilities (KSAs)