Senior Specialist, Benefit Sales (In Field - Brooklyn, NY)

Molina Healthcare•Brooklyn, NY

21h•Onsite

About The Position

Provides senior level support for member enrollment activities including identifying, interviewing and screening prospective eligible members for Molina health insurance products, assisting with health plan selection and enrollment processes, processing paperwork and ensuring documentation accuracy and follow-up. Also develops and maintains relationships with local community agencies, health care organizations, and county/state agencies that refer potential eligible members, and represents at community-based outreach events to aid enrollment efforts. The role also assists with inbound/outbound calls to support facilitated enrollers with enrollment goals, leads projects, and provides support across initiatives including quality checks to marketing tracking. The specialist works with leadership to support enrollers and formulate resolutions for those missing enrollment expectations, identifies challenges, and communicates them. They successfully maintain and/or manage the monthly facilitated enrollment calendar, demonstrating strong time-management skills to handle multi-faceted projects with little to no supervision. This position participates in the design and implementation of enrollment-related process improvements, maintains a high level of professionalism, and possesses expert knowledge of current enrollment-related processes, rules, and regulations, serving as a resource and providing training to the facilitated enroller team. They offer solutions to leadership regarding corrective action plans, conduct quality activities, perform research assignments, and monitor daily enrollment operations to identify needs and work with leadership to meet goals. The specialist meets with prospective members at various community sites, providing education and support, assisting with applications, explaining requirements, and ensuring documentation completion, all while maintaining member privacy in accordance with HIPAA.

Requirements

At least 3 years of experience in health care, and/or customer/provider services experience, including at least one year of experience working with state and federal health insurance programs and populations, or equivalent combination of relevant education and experience.
Marketplace Certified (Valid, unrestricted NYSOH Certified Application Counselor ID – CAC) or ability to obtain certification within 30 days of hire.
Must have reliable transportation and a valid driver's license with no restrictions.
Interpersonal/customer service skills.
Data processing and proofing experience.
Attention to detail, organizational and time-management skills, and ability to work independently and meet internal deadlines.
Positive attitude and ability to adapt to change.
Knowledge of managed care insurance plans.
Ability to work with a diverse population, including different ethnicities, cultural backgrounds, and/or underserved communities.
Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA).
Ability to establish and maintain positive and effective work relationships with coworkers, members, providers and customers.
Effective verbal and written communication skills, including presentation skills.
Microsoft Office suite and applicable software programs proficiency.

Nice To Haves

Team lead experience.
Previous experience enrolling members into managed care programs/health insurance.
Bilingual – Spanish and English.

Responsibilities

Assists with inbound/outbound calls as necessary to support facilitated enrollers with achievement of monthly, quarterly and annual member enrollment goals.
Leads projects and provides support to facilitated enrollers to meet enrollment targets.
Provides support across initiatives, including quality checks to marketing tracking and works with leadership to successfully support facilitated enrollers in enrollment goals/formulate resolutions for enrollers missing enrollment expectations; identifies challenges and communicates accordingly to leadership.
Successfully maintains and/or manages monthly facilitated enrollment calendar.
Demonstrates strong time-management skills including the ability to maintain multi-faceted projects - ensuring both quality and quantity deliverables, while completing job duties and adhering to various objectives with little to no supervision.
Participates in the design and implementation of enrollment-related process improvements within the current facilitated enrollment policies, procedures, services and workflows to improve the customer experience and productivity.
Maintains a high-level of professionalism in all internal/external communications.
Maintains expert knowledge of current enrollment-related processes, rules and regulations of all applicable plans/programs, serves as a resource for implementation, and provides training to facilitated enroller team.
Offers solutions to facilitated enrollment leadership regarding corrective action plans (CAPs), and conducts other quality activities to include policy and procedure and enrollment application reviews.
Performs research assignments as directed by facilitated enrollment leadership which may include but are not limited to sourcing educational resources and best practices for the enrollment team.
Monitors daily enrollment operations, identifies needs related to program tools/resources, and works with facilitated enrollment leadership to meet enrollment function needs and goals.
Meets with prospective members at various sites throughout applicable communities - providing education and support to prospective members navigating complexities of the health care system - assisting with the application process, explaining requirements and ensuring documentation completion.
Demonstrates comprehensive understanding of enrollment processes, best practices, and indications with minor errors.
Maintains high-regard for member privacy in accordance with the Health Insurance Portability and Accountability Act (HIPAA), and internal policies and procedures.
Local travel required.