The Marketplace Facilitated Enroller is responsible for identifying prospective members that do not have health insurance and enrolling them into one of the government programs offered by Healthfirst such as Medicaid, Child Health Plus (CHP), Essential Plan (EP) or a Qualified Health Plan (QHP).
We are seeking candidates with great attention to detail and the ability to be patient and provide members with top notch customer service. Must be organized, detail oriented, and able to work independently. Excellent team player with the ability to work collaboratively both internally and externally.
Marketplace Facilitated Enrollers are required to travel frequently throughout the NYC boroughs, Nassau and Suffolk counties.
- Identify and educate potential members on all aspects of the plan including answering questions regarding plan's features and benefits. Responsible for identifying and assisting current members who are due to recertify their healthcare coverage for Medicaid, EP, QHP and CHP by completing member's annual recertification application including adding on additional eligible family members.
- Refer all existing members up for recertification to on site Retention Specialist when applicable.
- Assist members with selecting a Primary Care Physician (PCP) using the Healthfirst provider directory via the provider search tool. This includes verifying the correct PCP in OnContact and making any necessary changes based on member's request.
- Maintain adequate Book of Business (BOB) at all times, while adhering to the BOB policies and procedures. Complete enrollment activity through the NYSOH marketplace.
- Meet application goals while adhering to regulatory and state compliance. Enrollment activities includes on site coverage at hospitals, provider offices, City agencies, community business partners and Community Based Organizations (CBO's). All activity entered into Saleslogix (SLX) and PHSP Tracker tool.
- Conduct home visits and other appointments as needed to complete the application and obtain all required documentation.
- Review all applications prior to submitting to NYSOH marketplace. Complete a Conflict of Interest (COI) form and Marketplace Facilitated Enroller Disclosure & Applicant Authorization Form (PII) via Docusign for every enrollment encounter. Raise any additional training needs to management.
- Maintain an adequate supply of renewal materials required to complete the recertification applications.
- Maintain and carry Conflict of Interest (COI) forms at all times.
- Successfully meet pre and post training and regulatory exams and audit requirements.
- Complete annual NYSOH marketplace recertification requirement and complete Annual Corporate Compliance and Sexual Harassment Training requirements and any required training from City Department of Health (CDOH) or Human Resources Administration (HRA). Understand and implement the Plan's policies and procedures for the facilitated enrollment and renewal process.
- Establish and maintain good working relationships with external business partners such as hospital and provider organizations, City agencies, small businesses and Community Based Organization personnel where enrollment activities are conducted. Develop and strengthen relations in order to generate new opportunities for Healthfirst including new sites and event requisitions.
- Participate in health related activities / special events including evening and weekend activity. Events include health fairs, parades, holiday theme events, trade show expos, hospital orientations, provider sponsored events and health related theme events.
- Arrive at scheduled work site, team meetings, training sessions and events in accordance to departmental policy.
- Notify manager and Sales Audit Department when closing a site in accordance to the Sales Operation policy. Participate in weekly, bi-weekly and monthly staff meetings and trainings including one-on-one meetings with management. Provide information to management on opportunities at current or potential marketing sites. Raise any issues / concerns to management relative to site coverage, competition, training needs and process improvement.
- Remain knowledgeable of competitor's products, marketing practices and keep management informed of such products and practices.
- Recommend process improvement and advise management of any proposed recommendations that can make a workflow or process more efficient.
* Knowledge of Medicaid, Essential Plan, Child Health Plus, Qualified Health Plan, Medicare or any other healthcare product line
* Daily access to a vehicle with valid proof of insurance
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
If you have a disability under the Americans with Disability Act or a similar law, and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to ...@Healthfirst.org or calling 212-###-#### . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.
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