Health Counselor

The Community Service Society (CSS) is an independent, not-for-profit organization that has been at the forefront of public policy innovations that support low-income New Yorkers for more than 170 years.

CSS’s Health Initiatives Department runs several statewide programs that help New Yorkers find and use their health insurance or otherwise access health care.

In October 2018, CSS launched New York State’s first ombudsman program targeting the needs of people with mental illness and/or substance use disorder, Community Health Access to Addiction and Mental Healthcare Project (CHAMP).

CHAMP operates statewide through a toll-free live-answer helpline and in partnership with eight community-based organizations and three specialist organizations. The goal of CHAMP is to help people with substance use and mental health care needs navigate and secure benefits through their insurance plans.

The CHAMP Helpline fields calls from people who need help getting and using health insurance coverage for substance use disorder and mental health care, serving not only those in need of care but also their family members, care providers, and other advocates. CSS seeks to hire a Health Counselor who will provide high-quality consumer assistance through the CHAMP Helpline to clients with mental health conditions or substance use disorder, their family members, and health care providers, helping them navigate the difficulties they may face in accessing care.

Job Responsibilities

• Respond to live calls from consumers, family members and providers on the CHAMP Helpline, including during extended Helpline hours (until 7pm) approximately once per week.
• Assist with filing grievances, complaints, appeals, and provide hearing and/or appeal assistance to consumers contesting denials of health insurance coverage.
• Assist consumers with filing grievances, complaints, appeals contesting denials of health insurance coverage.
• Assist with document collection and evaluation for prior authorization requests, peer-to-peer reviews, and appeals.
• Provide information, education, advice, and navigational services to consumers on how to successfully use health insurance and/or access care.
• Maintain thorough case records of services provided, advice, appeals, and/or referrals.
• Help identify systemic trends or practices that adversely affect consumers and work closely with senior CSS staff and other appropriate stakeholders.

Job Requirements

• Graduate degree in social work, health policy, public health, biology, or other relevant discipline preferred.
• A minimum of one year's experience providing assistance to consumers and/or advocates on health insurance or health care access issues preferred; experience working with people with substance use disorders and/or mental health conditions strongly preferred.
• Outstanding research, writing, and oral advocacy skills required, including excellent reading comprehension, organized thought, and the ability to speak, type, and write clearly, concisely, and persuasively; keeping detailed notes of all communications required.
• Outstanding organizational skills and attention to detail required.
• Excellent oral communication skills, including a genuine enjoyment of talking with people on the phone and the ability to project patience, competence, and care for others' concerns through both oral and written communication.
• Customer service and written advocacy experience preferred.
• Mission driven.
• Written and spoken fluency in Spanish preferred.
• Competency with Office Suite and Salesforce, along with research and data-based management skills, preferred.

Compensation: This position is represented by local 1199 SEIU with an annual salary of $85,395.00 including comprehensive medical, dental, and vision coverage provided by 1199. Community Service Society provides an employee benefit package including 403b retirement savings plan, defined benefit retirement plan, commuter benefit plan, EAP, and more in addition to a robust paid time off policy.

Additional details: Must be authorized to work in the United States.

Physical Requirements: Office work that requires sitting, use of a computer, answering phone calls, participating in virtual meetings, and other standard office functions.

CSS currently offers a hybrid work environment requiring on-site work at CSS’ office at least two days per week and three days per week of remote work. CSS will provide all equipment necessary to perform the job from home, but the employee must have their own wired internet connection.

• ## Interested applicants should provide a cover letter and resume at the time of application submission

• CSS is an Equal Employment Opportunity/Affirmative Action employer. We do not discriminate on the basis of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, age, disability, military status, or any other characteristic protected by applicable federal, state, or local law.

CSS complies with all applicable federal, state, and local laws governing employment, recruitment, and hiring.