Licensed Health Insurance Agent

TEKsystems•Virginia Beach, VA

3d•$22 - $23•Remote

About The Position

This position will start by focusing on DSNIP (Dual Eligible Special Needs Plan) and then switch over to Individual Plan during open enrollment season later in the year (October 1). DSNIP is a type of Medicare Advantage plan specifically designed for individuals who are "dual eligible", meaning they qualify for both Medicare and Medicaid. Sentara Health offers a Dual Eligible Special Needs Plan (DSNP) called Sentara Community Complete (HMO D-SNP). The government recently updated regulations to say that whatever plan a member has for Medicare, they have to use the same insurance company for their Medicaid. Sentara is the biggest Medicaid provider in Virginia and they do not want to lose any more members. Any Dual Members can make changes to their policy once per month so this is a constant project and a huge push for Sentara right now. They have 10 different mailing campaigns going out between end of May - end of December so are expecting a lot of call volume from this. The team will be focused on DSNP for a majority of the time between their start to AEP (October 1) - then their focus will shift to Individual Plan. The volume will be very high but when inbound calls are not coming in - they will be handling outbound projects. Examples of outbound projects include calling people who are referred for DSNP alignment, CSNP retention efforts (requiring proof of chronic illness and certain medical documents), and calling individuals aging off their parents' plan to get them enrolled in a plan. The expectation is a minimum conversion of calls to sales of 6%, aiming for 10 enrollments per week.

Requirements

Must have Virginia insurance license, have or be eligible for AHIP certification, Medicare and/or Contact Center experience.
Licensed Health Insurance
Need to be licensed in the state of Virginia (if out of state, will take if open to getting out-of-state license).
Need to get certified for Marketplace plans through CMS (free).
Must have health insurance sales experience.
Computer skills - use Oracle, Microsoft Office especially MS Teams.
Understanding of Medicare / DSNIP and Individual plan.
Positive, upbeat personality.
Quick learner but trainable and takes feedback well.

Nice To Haves

Sentara Health offers a Dual Eligible Special Needs Plan (DSNP) called Sentara Community Complete (HMO D-SNP), designed for individuals who qualify for both Medicare and Medicaid.
Sentara Health’s DSNP strategy is centered around the "Exclusively Aligned Enrollment" model, which became mandatory in Virginia starting January 1, 2025.
This model requires that members who are dual-eligible must receive both their Medicare and Medicaid benefits from the same health plan.
Sentara is looking to get DSNIP Alignment of 11,000 Medicaid Members.
Any Dual Members can make changes to their policy once per month so this is a constant project and a huge push for Sentara right now.
They have 10 different mailing campaigns going out between end of May - end of December so are expecting a lot of call volume from this.
Our team will be focused on DSNP for a majority of the time between their start to AEP which is October 1- then their focus will shift to Individual Plan.
The volume will be very high but when inbound calls are not coming in - they will be handling outbound projects.
Some examples of outbound projects- Care coordinators (medicaid side of business) send referrals - these people can be aligned to DSNP - the team will call CSNP retention efforts - need to show proof of chronic illness and certain medical documents to stay enrolled IFP - Kids aging off their parents plan over 26- calling them to get enrolled in a plan.
Expectation - Minimum conversion of calls to sales- 6% 10 enrollments per week is a good number to shoot for.

Responsibilities

Educating beneficiaries about products and their healthcare options, and helping them make an informed decision on which plan is most appropriate for their individual health needs.
Selling Dual Eligible Special Needs Plan (D-SNP) to eligible beneficiaries telephonically.
Strict adherence to the Centers for Medicare and Medicaid Services (CMS) Sales and Marketing regulations and Sentara Health Plan policies and procedures.
Only selling Sentara Health Plan products.
Maintaining yearly appropriate training and licensure renewal as required.
Taking incoming calls from potential members who are looking to see if they qualify to enroll for coverage.
Evaluating information provided by prospective members to determine if they qualify for an Individual or DSNIP Plan.
Providing insurance coverage quotes and educating prospective members on plan inclusions and offerings.
Completing the enrollment if the caller would like to move forward with the plan.
Informing callers who are not eligible about who they can call for more information.
Transferring calls from those who call into the wrong department.
Making outbound calls to families whose dependents are aging off of a plan and offering individual quotes to those during downtime.