Specialist, Benefit Sales-Queens, NY

Molina Healthcare•Long Beach, NY

About The Position

Provides support for member enrollment activities for Molina health insurance products. The role identifies, interviews, and screens prospective eligible members; assists with health plan selection and enrollment; processes paperwork; ensures documentation accuracy; and follows up as needed. It also develops and maintains relationships with community agencies, health care organizations, and county and state agencies that refer potential members, and represents Molina at community outreach events to support enrollment efforts. The Specialist is responsible for meeting enrollment and growth targets, helping prospective and current members navigate enrollment and recertification, explaining plan features and requirements, and submitting applications in accordance with state-specific deadlines and Molina guidelines. The position includes local travel, community outreach, and occasional evening or weekend events.

Requirements

At least 2 years of experience in health care and/or customer or provider services, including at least 1 year working with state and federal health insurance programs and populations, or an equivalent combination of relevant education and experience.
Marketplace Certified with a valid, unrestricted NYSOH Certified Application Counselor ID (CAC), or ability to obtain certification within 30 days of hire.
Reliable transportation and a valid, unrestricted driver's license.
Interpersonal and 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 diverse populations, including different ethnicities, cultural backgrounds, and underserved communities.
Ability to maintain confidentiality and comply with HIPAA.
Ability to establish and maintain positive and effective work relationships with coworkers, members, providers, and customers.
Effective verbal and written communication skills, including strong presentation skills.
Proficiency with Microsoft Office suite and applicable software programs.

Nice To Haves

Previous experience enrolling members into managed care programs or health insurance.
Bilingual in Spanish and English.

Responsibilities

Meet monthly, quarterly, and annual member enrollment goals and growth targets.
Facilitate inbound and outbound calls to interview and screen prospective members and assist them with enrollment in qualified Molina health plans.
Meet prospective members at various sites within applicable communities.
Help prospective members navigate the health care system and application process by explaining requirements and providing necessary documentation.
Educate prospective members about applicable plan features and benefits, answer questions, and explain required disclosures.
Educate members about premium payment options and due dates.
Assist members with selecting a health plan and primary care physician.
Submit completed applications by state-specific deadlines and in accordance with Molina enrollment guidelines and requirements.
Assist current members who are due to recertify coverage by completing annual recertification applications, including adding eligible family members.
Respond to prospective member inquiries in accordance with marketing guidelines.
Follow applicable health plan rules and regulations for member enrollment.
Participate in assigned events and community outreach projects with other agencies for a minimum of eight hours per week.
Establish and maintain working relationships with external business partners, including hospitals, provider organizations, city agencies, and community-based organizations.
Develop and strengthen relationships to generate new opportunities.
Attend community health fairs, events, and external meetings as required.
Attend occasional weekend or evening special events as needed.
Travel locally as required.