Coverage Assistance Coordinator

SUMMARY

The Coverage Assistance Coordinator serves as a critical connector between the inpatient hospital, outpatient clinics, and community-based resources. This role supports patients with Medi-Cal Full Scope enrollment, Hospital Presumptive Eligibility (HPE), redetermination, and complex social, behavioral, and medical needs. Work in close collaboration with the inpatient Community Health Worker (CHW) team to serve as a bridge in supporting patients across care settings.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Includes, but is not limited to the following:

• Assist uninsured and underinsured patients with Medi-Cal Full Scope enrollment, HPE applications, and redetermination/renewal.
• Serve as a bridge coordinator to support coverage between inpatient and outpatient systems.
• Identify and engage high-risk patients during inpatient stays, Emergency Department visits, or outpatient encounters.
• Serve as a knowledgeable resource regarding eligibility requirements and coverage pathways.
• Coordinate with eligibility teams, hospital partners, and county agencies to ensure timely activation of coverage.
• Serve as a liaison between inpatient teams, outpatient clinics, case management, social work, pharmacy, nursing, outpatient teams, and community partners.
• Participate in huddles and multidisciplinary case review meetings, including complex patient huddles.
• Collaborate with internal and external partners (e.g., hospital departments, health plans, county services, clinics, and community-based organizations).
• Document all patient interactions, interventions, and outcomes accurately in the electronic health record.
• Track patient progress, interventions, and outcomes for reporting and quality improvement.
• Support data collection, evaluation, and performance improvement initiatives related to care transitions and population health.
• Serve as a subject-matter resource for staff and community partners related to coverage assistance programs.
• Conduct comprehensive social determinant of health (SDOH) assessments and identify barriers to care.
• Maintain regular follow-up with assigned patients to support adherence, continuity of care, and maintain coverage for all patients.
• Support the continuity of care for patients during provider visits, hospital discharge transitions, classes, or approved community appointments.
• Other duties as assigned

EDUCATION and/or EXPERIENCE

• High School Diploma or GED required; Associate's or Bachelor's degree preferred.
• Community Health Worker Certification strongly preferred.

REQUIRED LICENSES/CERTIFICATIONS

• Community Health Worker Certification strongly preferred.

PREFERRED

Bilingual skills may be required at certain clinics or during certain shifts.

CONDITIONS OF EMPLOYMENT:

Proof of identity and legal authority to work in the U.S. is a condition of employment. Cypress Healthcare Partners/Salinas Valley Health Clinics will not sponsor applicants for work visas.