Medicare Outreach Agent (bilingual - Spanish)

Santaclara Family Health Plan•Gilroy, CA

70d

About The Position

The Medicare Outreach Agent executes SCFHP's Medicare outreach and enrollment operations to grow SCFHP Medicare enrollment in compliance with all applicable state and federal regulatory requirements, SCFHP policies and procedures, and business requirements, and in support of organizational objectives.

Requirements

Associate's Degree in a related field of study, or equivalent training/experience. (R)
Minimum two years of Medicare sales, Medicare benefits advisory work, or Medi-Cal eligibility advisory work experience. (R)
Strong presentation skills with intent to sell. (R)
California Life, Accident and Health Insurance License, or the ability to obtain within 60 days of employment. (R)
Self-directed with proven ability to assume responsibility, work independently, meet deadlines and prioritize with minimum supervision. (R)
Maintenance of a valid California driver's license and acceptable driving record, in order to drive to and from offsite meetings or events; or ability to use other means of transportation to attend offsite meetings or events. (R)
Experience with, and understanding of, Medicare outreach and/or sales. (R)
Ability to establish and maintain effective working relationships with providers, community based organizations and program participants. (R)
Bilingual in Spanish, Vietnamese, Mandarin or Cantonese. (R)
Ability to work nights and/or weekends as needed. (R)
Working knowledge of and the ability to efficiently operate all applicable computer software including a working knowledge of computer applications such as Outlook, Word and Excel. (R)
Ability to use a keyboard with moderate speed and a high level of accuracy. (R)
Excellent communication skills including the ability to express oneself clearly and concisely when providing service to beneficiaries, SCFHP members, providers and outside entities in person, over the telephone, or in writing. (R)
Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R)
Ability to take initiative and exercise good judgment when making decisions within the scope of the position. (R)
Ability to maintain confidentiality. (R)
Ability to comply with all SCFHP policies and procedures. (R)
Ability to perform the job safely with respect to others, to property, and to individual safety. (R)

Nice To Haves

Experience with managed care and Medi-Cal. (D)
Knowledge of current trends, practices, strategies, tools for outreach and sales, including customer relation management applications. (D)

Responsibilities

Execute sales and outreach strategy to maximize membership growth, including meeting Medicare enrollment goals as well as individual sales and performance goals.
Ensure timely follow-up on questions, issues and concerns from beneficiaries, members, providers, community partners.
Organize and conduct sales presentations in the community and assist eligible beneficiaries to enroll, including conducting a needs assessment to best explain product offerings.
Make outbound calls to follow up and close business; receive and manage inbound enrollment calls.
Manage and execute outreach plan to providers and community based organizations to support achievement of Medicare enrollment objectives.
Seek opportunities to improve SCFHP image/visibility in the community. Contribute ideas to increase retention and enrollment.
Develop, maintain and use competitive analysis to inform outreach and retention efforts, including identifying and studying key competitors and their products, as well as related industry issues to maintain a personal awareness of competitive advantages and disadvantages; share the competitive analysis with the Marketing and Outreach teams.
Stay current on SCFHP product and competing products; stay current on CMS Medicare Marketing Guidelines and with California specific Medicare-Medicaid Plans Medicare Marketing Guidelines.
Successfully complete SCFHP required product and certification training; maintain California Life, Accident and Health Insurance License.
Identify issues and trends (data, systems, beneficiary, member, provider, other) as well as general departmental questions/concerns and report relevant information to management; make recommendations.
Address member questions, concerns, grievances, appeals or requests for services in accordance with policies and procedures, including appropriate documentation and communication with other departments.
Assist with new hire training by having new hires shadow, observe in the community, and listen to calls, in accordance with training guidelines and protocols. Observe new hires and provide feedback to the Department Manager.
Attend and actively participate in daily, weekly, and monthly departmental meetings, training and coaching sessions.
Perform other related duties as required or assigned.