Field Entitlement Enrollment Team Lead

HF Management Services•New York, NY

12d

About The Position

The Retention Advocate Team Lead oversees the activities of the Sr Retention Advocate team who are responsible to provide Healthfirst members support in obtaining financial entitlements for which they are eligible. This enables members to maintain the highest level of independence both at home and within their communities. The SRA team provides education within our lines of business, assists our members in applying and continuous follow up to eligibility. They are responsible for a longer cycle of work. Healthfirst has a paperless work environment requiring daily hands-on administration of multiple proprietary and packaged electronic databases including security requirement tools such as encryption. These systems include, but are not limited to, Salesforce, Trucare, Outlook, MS Office, e|fax, Interaction Client, VoIP, Virtual Work Platforms (using VPN), and scanning. Duties & Responsibilities : Supervises Retention Advocates- This includes observing staff in the field (travel within NYC, Westchester and Nassau counties) and conducting customer phone audits to ensure all activities are completed in accordance with Company protocols and State regulations Coordinates a synchronized workflow while maintaining the integrity of member confidential information, as well as proprietary business information in collaboration with staff in Marketing, Relationship Coordinators, Growth Team, and Referral Sources Tracks the designated application process and outcomes, to meet department enrollment conversion goals Addresses patterns of appointments outcomes: Not interested, re-scheduled or cancelled members Conducts monthly audits established by yearly Goals in the areas of Medicaid, Medicare and Customer Service surveys, tracking of all applications/documents Directs the Entitlement process by explaining features to callers, entering activities into proprietary Employee Medical Records system, responding to questions from enrollees/significant others and resolving daily routine problems including complicated cases Prepares monthly summary reports for Manager/Director/VP Operations to show status of applications and Conversions Keeps up to date on product laws and changes. Shares all updated information with Team members as appropriate Contribute to continuous performance improvements, this includes but not limited to, monitoring staff effectiveness based on productivity, conversions, documentation, accuracy of data entry, and overall timeliness of the intake, assessment, and application process Ability to multitask and remain focused in an environment with distractions Follows protocols and use common sense to escalate situations to management or other Healthfirst teams appropriately Handles other duties as assigned with the occasional need to work weekends, on-call, additional hours before or after shift schedule and/or from other HF site locations Additional duties as necessary

Requirements

High School Diploma or GED equivalent
Prior experience with Medicaid /Medicare/MSP applications
Experience supervising and delegating to others
Effective oral and written communication skills
Organized, detail oriented, and able to adapt to procedural and other business information changes
Strong data entry skills, must be able to maintain monthly spreadsheets for tracking and statistical purposes
Must be able to travel throughout the 5 boroughs, Westchester, Orange, Sullivan, Rockland, and Nassau County.

Nice To Haves

Bachelor’s degree from an accredited institution
Monitors and acts on feedback to ensure Member/Client satisfaction
A solid understanding of the value of integrated care.

Responsibilities

Supervises Retention Advocates- This includes observing staff in the field (travel within NYC, Westchester and Nassau counties) and conducting customer phone audits to ensure all activities are completed in accordance with Company protocols and State regulations
Coordinates a synchronized workflow while maintaining the integrity of member confidential information, as well as proprietary business information in collaboration with staff in Marketing, Relationship Coordinators, Growth Team, and Referral Sources
Tracks the designated application process and outcomes, to meet department enrollment conversion goals
Addresses patterns of appointments outcomes: Not interested, re-scheduled or cancelled members
Conducts monthly audits established by yearly Goals in the areas of Medicaid, Medicare and Customer Service surveys, tracking of all applications/documents
Directs the Entitlement process by explaining features to callers, entering activities into proprietary Employee Medical Records system, responding to questions from enrollees/significant others and resolving daily routine problems including complicated cases
Prepares monthly summary reports for Manager/Director/VP Operations to show status of applications and Conversions
Keeps up to date on product laws and changes. Shares all updated information with Team members as appropriate
Contribute to continuous performance improvements, this includes but not limited to, monitoring staff effectiveness based on productivity, conversions, documentation, accuracy of data entry, and overall timeliness of the intake, assessment, and application process
Ability to multitask and remain focused in an environment with distractions
Follows protocols and use common sense to escalate situations to management or other Healthfirst teams appropriately
Handles other duties as assigned with the occasional need to work weekends, on-call, additional hours before or after shift schedule and/or from other HF site locations
Additional duties as necessary