Job Description

Provides support for community-based member advocacy activities with regard to transitioning from children services to adult services and preparing for adult responsibilities. Serves as a local member advocate and resource, using knowledge of the community and resources available to engage and assist vulnerable members in managing health care needs as they transition to adulthood. Contributes to overarching strategy to provide quality and cost-effective member care. Designated expert with knowledge and experience of GOT Transition, Florida Youth to Adult Transition, and other nationally recognized TAY programs to work alongside Care Managers to support enrollees’ TAY needs. TAY Specialists are responsible of assisting care managers with identifying and linking members to Transition programs and monitoring and reporting transition outcomes.

Essential Job Duties

• Engages with members as an advocate and resource to support management of health care needs.
• Collaborates with and supports the health care services team by providing non-clinical paraprofessional duties in the field to include meeting with members in their homes, nursing homes, shelters, provider offices, etc.
• Empowers members by helping them navigate and maximize their health plan benefits. Assistance may include: scheduling appointments with providers, arranging transportation for health care visits, getting prescriptions filled and following-up with members on missed appointments.
• Assists members in accessing social services such as community-based resources for housing, food, employment, etc.
• Provides outreach to locate and/or provide support for disconnected members with special needs.
• Conducts research with available data to locate members that Molina has been unable to contact (e.g., reviewing internal databases, contacting member providers or caregivers or travel to last known address or community resource locations such as homeless shelters, etc.)
• Participates in ongoing or project-based activities that may require extensive member outreach (telephonic and/or face-to-face).
• Guides members to maintain Medicaid eligibility and with other financial resources as appropriate.

Required Qualifications

• At least 1 year of health care experience, preferably working with underserved or special needs populations with varied health, economic and educational circumstances, or equivalent combination of relevant education and experience.
• Community Health Worker (CHW) certification may be required for certain states (dependent upon contractual requirements).
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.
• Ability to multi-task applications while speaking with members.
• Excellent customer service skills.
• Organizational and time-management skills.
• Ability and willingness to learn other lines of business, programs and relevant software systems/applications.
• Excellent verbal and written communication skills.
• Microsoft Office suite/applicable software program(s) proficiency.

Preferred Qualifications

• Community Health Worker (CHW) certification (for states other than Ohio, Florida and California, where it is required).
• Certified Medical Assistant (CMA).
• Bilingual based on community need.
• Familiarity with health care systems.
• Knowledge of community-specific culture.
• Experience with/or knowledge of health care systems, community resources, social services, and/or health education

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To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V