ORGANIZATION OVERVIEW: At Catholic Charities of the Archdiocese of Washington, your knowledge and service in areas such as immigrants and refugees, mental health, social work, employment, and adult education, legal and financial services, health care, food assistance, shelter and housing, developmental disabilities and prison outreach can make a profound difference in the lives of many. Through more than 50 programs across the district and five surrounding counties, Catholic Charities is opening doors to help and hope. At CCADW, we continue to build an inclusive culture that celebrates a diverse workforce. We offer so much more than just a job. We offer careers. We take pride in our “promote from within” culture. We offer professional development, a comprehensive benefits package, a hybrid work model with both remote and in-office work, and a passion for building and motivating world-class, high-performing teams. Explore your career opportunity with Catholic Charities. Join us in Inspiring Hope and Building Futures.

Catholic Charities of the Archdiocese of Washington values the safety of our employees, our clients, and our visitors. In support of these values, if you are selected for this job, you must be fully vaccinated against COVID-19, except when vaccination is not medically advised or violates your sincerely held religious beliefs. If you are invited to join our team, you must submit proof that you are up to date with your COVID vaccinations, including the booster dose or you must request an exemption from your representative. New employees must either provide proof of vaccination or be granted a medical or religious exemption before working with Catholic Charities of the Archdiocese of Washington.

JOB SUMMARY: The Eligibility Specialist of the Catholic Charities Health Care Network (CCHCN) reviews and approves specialty eligibility applications and provides feedback to all primary care clinic staff regarding the eligibility screening and approval process.

ESSENTIAL DUTIES and RESPONSIBILITIES:

• Act as the primary contact for the program’s eligibility process with clinic staff.
• Approve applications and maintain individual program eligibility in the system. On the first day of each month, reports on the number of eligibilities screened, approved or denied.
• Review specialty eligibility applications in Community Health Link Cares (CHLC) to ensure completeness and clarity of information submitted.
• Communicate documentation discrepancies and follow up with patients to submit the appropriate proof of documents within ten business days (two weeks).
• Maintain confidential patients’ records for the program.
• Respond to incoming calls, provide information about the eligibility process, and refer any eligibility inquiries accordingly.
• Act as an advocate for patients needing additional information, support, or services.
• Discuss any problems related to the eligibility process with the Program Manager or Nurse Case Manager to resolve problems.
• Teach CHL class every 1st month of the quarter. Ensure Clinics and patients understand the range of services offered, i.e., sliding fee scale, Patient Agreement, and Privacy Rights.
• Maintain and promote a positive image of CCHCN to existing and potential clients.
• Participate in Quality Improvement projects, collect data and provide suggestions. Generate ideas for improvement and participate in their testing and implementation when required. Incorporate the resulting guidelines from the quality improvement initiatives and process into job duties.

EDUCATION and EXPERIENCE:

• High school diploma or associate degree.
• One year of experience working with low-income, uninsured, and ethnically diverse populations, preferably in a healthcare setting/organization.

SKILLS and COMPETENCIES:

• Bilingual English/Spanish.
• Ability to communicate effectively verbally and in writing.