State Programs Member Engagement Specialist (Facilitated Enrollment) Job at Healthfirst (New York)

Job Description

The MarketPlace Facilitated Enroller is responsible for identifying and educating potential members on all aspects of the plan including new Medicaid, CHP/EP/QHP and answering questions regarding plan’s features and benefits. Responsible for identifying and assisting current members who are due to recertify their healthcare coverage for Medicaid, EP, QHP and CHP by completing member’s annual recertification application including adding on additional eligible family members.

Job Responsibility

Identifying and educating potential members on all aspects of the plan including new Medicaid, CHP/EP/QHP and answering questions regarding plan’s features and benefits
Identifying and assisting current members who are due to recertify their healthcare coverage for Medicaid, EP, QHP and CHP by completing member’s annual recertification application including adding on additional eligible family members
Engage in enrollment activities over the phone or in person through onsite coverage at hospitals, provider offices, City agencies, community business partners and Community Based Organizations (CBO’s)
Complete and review all applications prior to submitting to NYSOH marketplace
Assist members with selecting a high-quality Primary Care Physician (PCP), order member ID card and make monthly premium payment
Manage inbound and outbound telephonic enrollment process as a part of the Sales enrollment
Educate members about digital tools including HF mobile application, Twilio, as well as NowPow
Maintain and complete adequate Book of Business (BOB) for all encounters and leads on daily basis
Conduct group educational seminars /presentations including Healthfirst products and services as well as preventive care educations in person or virtually
Participate in health-related activities / special events including evening and weekend activities
Establish and maintain good working relationships with external business partners such as hospital and provider organizations, City agencies, small businesses and Community Based Organization personnel
Maintain current working knowledge of product benefits, formulary, sales system functionality, policies and procedures
Must stay abreast on changes to all lines of business
Follow the protocol and guidelines provided by the sales auditing department regarding the schedule and site changes
Maintain an adequate supply of marketing materials
Arrive at scheduled work site, and all activity events in accordance to the departmental attendance policy
Participate in weekly, bi-weekly and monthly staff meetings, one-on-one meetings with management as well as required training sessions
Successfully meet pre and post training, regulatory exams as well as audit requirements
Complete annual NYSOH marketplace recertification requirement, Annual Corporate Compliance and Sexual Harassment Training requirements and any required training from City Department of Health (CDOH) or Human Resources Administration (HRA)
Provide information to management on opportunities at current or potential marketing sites
Remain knowledgeable of competitor’s products, marketing practices and keep management informed of such products and practices
Raise any issues / concerns to management relative to site coverage, competition, additional training needs

Requirements

Knowledge of Medicaid, Essential Plan, Child Health Plus, Qualified Health Plan, Medicare or any other healthcare product line
Basic knowledge of Microsoft Office (Excel, Word and PowerPoint)
Must have a GED or high school diploma

Nice to have

Associate or Bachelor's degree
Bilingual preferred

What we offer

medical, dental and vision coverage
incentive and recognition programs
life insurance
401k contributions

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State Programs Member Engagement Specialist (Facilitated Enrollment)

Job Description

Job Responsibility

Requirements

Nice to have

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State Programs Member Engagement Specialist (Facilitated Enrollment)

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