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.
Skills Required
- High School Diploma or GED
- Authorized to work in the U.S. (proof of identity and work authorization)
- Ability to document patient interactions accurately in an electronic health record (EHR)
- Associate's or Bachelor's degree
- Community Health Worker Certification
- Bilingual skills (may be required at certain clinics or shifts)
What We Do
Montage Health is a nonprofit healthcare organization with deep roots in Monterey County dating back more than 90 years. Independent and locally owned, Montage Health was created by Community Hospital of the Monterey Peninsula to deliver exceptional care to more people. Centered at the hospital, the Montage Health network includes MoGo Urgent Care, Montage Orthopedics and Sports Medicine Center, Montage Wellness Center, Montage Medical Group for primary and specialty care, Aspire Health Plan, and Ohana, a family-focused youth mental health program. Montage Health is continually investing in healthcare innovations to make the highest standard of care accessible to everyone in Monterey County.
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