Facilitated Enroller - Benefit Sales Specialist; In Field - Bronx, NY

Facilitated Enroller - Benefit Sales Specialist (In Field - Bronx, NY)

Job Summary

The Marketplace Facilitated Enroller (MFE) is responsible for identifying prospective members that do not have health insurance and assisting them with the enrollment process, ultimately making it easier for them to connect to the care they need. The MFE conducts interviews, screens potential recipients for enrollment into government programs such as Medicaid, Medicaid Managed Care, Child Health Plus, and Essential Plan, and assists enrollment into Qualified Health Plans.

The MFE must offer all plans and products, help families complete applications, gather necessary documentation, and assist in choosing the appropriate health plan. The MFE also provides information on managed care programs and how to access care, processes paperwork accurately, follows up on visit documentation, assists current members with recertification, and develops professional relationships with community agencies and county/state personnel who refer eligible recipients.

• Responsible for achieving monthly, quarterly, and annual enrollment goals and growth targets, as established by management.
• Interview, screen and assist potentially eligible recipients with the enrollment process into Medicaid/Medicaid Managed Care, Child Health Plus the Essential Plan and Qualified Health Plans for Molina and other plans who operate in our service area
• Meet with consumers at various sites throughout the communities
• Provide education and support to individuals who are navigating a complex system by assisting consumers with the application process, explaining requirements and necessary documentation
• Identify and educate potential members on all aspects of the plan including answering questions regarding plan's features and benefits and walking client through the required disclosures
• Educate members on their options to make premium payments, including due dates
• Assist clients with choosing a plan and primary care physician
• Submit all completed applications, adhering to submission deadline dates as imposed by NYSOH and Molina enrollment guidelines and requirements
• Responsible for identifying and assisting current members who are due to re-certify their healthcare coverage by completing the annual recertification application including adding on additional eligible family members
• Respond to inquiries from prospective members and members within the marketing guidelines
• Must adhere to all NYSOH rules and regulations as applicable for MFE functions
• Outreach Projects
• Participate in events and community outreach projects to other agencies as assigned by Management for a minimum of 8 hours per week
• Establish and maintain good working relationships with external business partners such as hospital and provider organizations, city agencies and community-based organizations where enrollment activities are conducted
• Develop and strengthen relations to generate new opportunities
• Attend external meetings as required
• Attend community health fairs and events as required
• Occasional weekend or evening availability for special events.

Required Education

HS Diploma

Required Experience

• Minimum one year of experience working with State and Federal Health Insurance programs and populations
• Demonstrated organizational skills, time management skills and ability to work independently
• Ability to meet deadlines
• Excellent written and oral communication skills; strong presentation skills
• Basic computer skills including Microsoft Word and Excel
• Strong interpersonal skills
• A positive attitude with ability to adapt to change
• Must have reliable transportation and a valid NYS drivers' license with no restrictions
• Knowledge of Managed Care insurance plans
• Ability to work with a diverse population, including different ethnicities, cultural backgrounds, and/or underserved communities
• Ability to work a flexible schedule, including nights and weekends

Required License, Certification, Association

Successful completion of the NYSOH required training, certification and recertification

Preferred Education

AA/AS – Associates degree

Preferred Experience

Previous experience as a Marketplace Facilitated Enroller

Bilingual

Spanish & English

Pay Range: $18.04 - $42.20 / HOURLY

• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.