Healthfirst

The Complete Care Specialist is responsible for developing and maintaining relationships, leads, and new business using consultative selling/marketing. This role serves as the key player in educating Medicare Advantage and Medicaid Advantage Plus (MAP) benefits to potential members in a manner that is compliant with Centers for Medicare & Medicaid Services (CMS) and Healthfirst’s policies. The Complete Care Specialist is a pivotal presence in the community and point|of|contact for current members.

Enrollment Process

• Ensure prospective members are enrolled properly and all internal and external processes are followed
• Using electronic pen technology ensures that the applications are electronically submitted
• Ensure that extra documents relative to the applications are faxed and submitted to the Enrollment Department such as, termination letter from another Medicaid Advantage Plan, Durable Power of Attorney, etc.
• Enter all information into an electronic book of business and supply supporting documentation to all new enrollees (copy of application, Low-income Subsidy (LIS) letter, a summary of benefit, etc.)

Communication, Listening & Speaking

Adjust communication style based on the audience such as, family members, care givers, social workers, colleagues, and anyone that will need to participate on behalf of the member during the sales process

Identify the prospective member(s) comprehension of products and services being discussed through varied techniques

Performance Requirements

• Develop and nurture relationships with prospective members, community leaders, owner hospitals, community partners, and current business partners. Must generate referrals to the Medicare Advantage and Medicaid Advantage Plus (MAP) plans to ensure individual enrollment quotas are met based on tenure
• Required to attend all Sales Meetings and gatherings. Must submit three reports daily: Plan of Action, Mid-day, and End-of-day
• Interact with others in professional situations, sharing useful knowledge, and developing long-term mutually beneficial relationships with others in the organization to maximize benefits to the organization
• Participate and help organize formal and informal networking events, interact with professionals within and across organizations, exchange useful information with coworkers, and develop relationships with key internal stakeholders
• Attend multiple networking events (e.g., seminars and conferences) while sharing useful information obtained with other organization members and colleagues collaborating to draw on an existing pool of network resources
• Establish partnerships with peers to carry out joint marketing efforts of shared sites
• Stay informed on all recent changes in regulations, recent training sessions, changes in workflow, and changes to Healthfirst’s benefits
• Achieve a passing score on post and ongoing quizzes, attend refresher training, and participate in administrative audits
• When summoned by the Special Investigation Unit (SIU) of Healthfirst, you will be adequately prepared, forthcoming with information and cooperative in answering questions using your electronic Blackberry and/or soft copies if applicable
• Minimize the number of mistakes in the field and take ownership of miscalculations by learning from it
• Follow Company, CMS, and state guidelines relative to Complete Care including all enrollment procedures
• Take personal responsibility to complete all online training regarding HIPPA, Marketing and Compliance reg

Technology

• Must be able to adapt to various software used by Healthfirst, maintain an electronic book of business, research participating providers, and communicate with internal departments via MS Outlook while safeguarding all Company issued equipment
• Must keep an open line of communication with Healthfirst Site Development business unit. This will consist of informing any organization that could be a suitable business partner for Healthfirst or any upcoming events you want to attend
• Must work in a concerted manner with Network Development and communicate with them any providers that we should attempt to recruit. Ensure Network Development Representatives are abreast of any outstanding issues relative to any of our participating providers
• Stay abreast of the changes in the industry and pass a post/ongoing training exam, as well as ensuring your staff are informed of any changes/updates

Minimum Qualifications: 

• High School Diploma or GED equivalent
• Medicaid, Medicare, MLTC, Commercial Sales, customer service, or retail experience
• Active NYS Accident & Health license
• Insured car and valid driver’s license depending on territory
• Bilingual

Hiring Range*:

• Greater New York City Area (NY, NJ, CT residents): $57,408 - $76,960

• All Other Locations (within approved locations): $49,795 - $72,800

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.

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, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.