Description |
Overview: The Facilitated Enroller - Spanish is responsible for identifying prospective members that do not have health insurance and enroll them into one of the government programs offered by Healthfirst such as Medicaid, Family Health Plus (FHP) and Child Health Plus (CHP). The FE is also responsible for assisting current Healthfirst members by recertifying them into Medicaid, FHP or CHP. Facilitated Enrollers are required to travel frequently throughout NYC boroughs, Nassau and Suffolk counties. Responsibilities: * Identify and educate potential members on all aspects of the plan including answering questions regarding plan's features and benefits and walking client through the required Blue List disclosures. Responsible for identifying and assisting current members who are due to re-certify their healthcare coverage for Medicaid, FHP and CHP by completing member's annual recertification application including addition on additional eligible family members. Refer all existing members up for recertification to on site Retention Specialists. Assist members with selecting a Primary Care Physician (PCP) using the Healthfirst provider directory on their Blackberry device. Maintain adequate Book of Business (BOB) at all times, while adhering to the BOB policies and procedures. Complete Blackberry encounters for all prospects deemed eligible and non-eligible. * Responsible for meeting new application goals and maintaining acceptable rejection levels while adhering to regulatory and state compliance. Enrollment activities includes on site coverage at hospitals, provider offices, City agencies, community business partners and Community Based Organizations (CBO's). Conduct home visits and other appointments as needed to complete the application and obtain all required documentation. Review all applications prior to submitting to Manager including proper supporting documentation and forms for all applicants. Complete required verification calls. Submit complete applications to manager at a minimum of three times per week using required Application Submission Forms (ASF) and batch forms. Adhere to 15-day application policy. Review rejections and update renewal applications accordingly for resubmission to management. Raise any additonal training needs to management of Field Trainer. Maintain an adequate supply of renewal materials required to complete the recertification applications. Maintain ample supply of Access New York Applications (ACNY), Addendums, Blue listings and Medicaid Long Forms at all times. Maintain and carry Facilitated Enroller Reference Binder (FERB) at all times. * Successfully meet pre and post training and regulatory exams and audit requirements. Attend quarterly refresher training and successfully meet testing requirements. Complete Annual Corporate Compliance and Sexual Harassment Training requirements. Attend any required training from City Department of Health (CDOH) or Human Resources Administration (HRA). Understand and implement the Plan's policies and procedures for the facilitated enrollment and renewal process. * 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 where enrollment activities are conducted. Develop and strengthen relations in order to generate new opportunities for Healthfirst including new sites and event requisitions. Participate in health related activities / special events including evening and weekend activity. Events include health fairs, parades, holiday theme events, trade show expos, hospital orientations, provider sponsored events and health related theme events. * Arrive at scheduled work site, team meetings, training sessions and events in accordance to departmental policy. Clock-in and clock-out using the Teletime system as required. Request PTO in a timely manner to provide minimal disruption to business activities and supply adequate site coverage. Notify manager and Sales Audit Department when closing a site in accordance to the Sales Operation policy. Participate in weekly, biweekly and monthly staff meetings and trainings including one-on-one meetings with management and Field Trainers (FT). Provide information to management on opportunities at current or potential marketing sites. Raise any issues / concerns to management relative to site coverage, competition, training needs and process improvement. * Remain knowledgeable of competitor's products, marketing practices and keep management informed of such products and practices. * Recommendation on process improvement. Advise management of any recommendation that can make a workflow or process more efficient. Qualifications: Minimum Qualifications: * High School Diploma * Incumbent must demonstrate a proven ability to use and operate a laptop and other technical devices * Basic knowledge of Microsoft Word and Outlook * Fluency in Spanish * At least 1 year of work experience in a telemarketing, customer service or field sales role * Must be able to perform in a fast paced environment operating in the community * This position requires frequent travel to marketing locations and prospect/member homes or place of work * Ability to work in indoor and outdoor environment * Ability to work flexible hours including evening and weekends as needed Preferred Qualifications: * 3 years of healthcare experience working in a Sales Marketing role * Any experience with the Medicaid application process Job Overview Department Name PHSP Facilitated Enrollment
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Requirements |
See job description.
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