Account Specialist -Bronx, Hudson, Orange, and Westchester County

    • Flexible / Remote

The Account Specialist is responsible for identifying prospective members who do not have health insurance, determine the appropriate plan for the individual or family and enroll them into one of the health programs offered by Healthfirst such as Medicaid, Child Health Plus (CHP), Essential Plan (EP), Qualified Health Plan (QHP), Medicare or Complete Care. Customarily and regularly works away from Healthfirst's place of business. The Account Specialist will collaborate closely with the Delivery Services Engagement team that works with providers, to identify provider related issues, address and resolve these issues as well promote Healthfirst to ensure visibility and increase market share. The Account Specialist will recertify members into Medicaid, CHP, EP, and QHP. This position will market exclusively in Westchester County .

  • Responsible for membership growth in strategic target areas (Orange, Putnam, Hudson and Westchester County )
  • Identifies potential members and designs a plan to educate potential members regarding the health benefits and care that is tailored for the member  as well as provide information  regarding the particular plan's features and benefits. 
  • For existing members, will review current benefits to determine appropriate plan, assist with recertifying their existing coverage or suggest transfer to alternative plan that is better aligned for their care. Will provide guidance and assistance to  recertify the member's  healthcare coverage for Medicaid, CHP, EP and QHP,  Medicare or Complete Care as well as  adding on additional eligible family members
  • Work collaboratively within a team to identify and develop business within  assigned territories
  • Discretion in choosing which providers to visit and the number of visits each day.
  • Partner with Community Engagement in order to organize events within the sales territory, including but not limited to health fairs, parades, holiday-themed events, trade show expos, hospital orientations, provider sponsored events  as well as  health-related theme events.
  • Responsible for scheduling  face to face meetings with Hospitals, IPA's, FQHC's and community providers to identify issues and ensure plan visibility. Alert DSE of  claim/rate related issues and  follow up with the results
  • Establish and maintain relationships with local community organizations to promote HF benefits in the community
  • Advance Healthfirst through superior customer service focused in an assigned territory, which will help optimize provider and member satisfaction
  • Conduct Provider portal orientation for new providers; educate the practice on how to navigate the provider portal (member eligibility, authorization, claim look up, membership roster, quality reports) to solidify the business relationship with providers and to support quality score improvement
  • Provide leads to DSE on new provider recruitment to diversify our network (FQHC, Dental, Pharmacy, Hospital, IPA, community providers)

Minimum Qualifications:

  • A Valid Drivers License
  • New York State Life Accident ( optional) & Health License (Mandatory)
  • Associate degree with experience in one of the following: sales, marketing, provider relations
  • 3 years of sales experience (1 year in health insurance industry)
  • Knowledgeable and experience working with provider network/hospital
  • Bilingual-English and one or more of the following: Yoruba, Twi, French, Wolos, Arabic, Spanish
  • Excellent communication & interpersonal skills (Oral & Written)
  • Good computer skills & tech savvy (Microsoft Office)

Preferred Qualifications:

  • Bachelor's Degree from an accredited institution
  • Account management experience
  • Medicaid and/or Medicare managed care experience

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 or calling 212-519-1798 . 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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