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
- 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)
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to 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.
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 careers@Healthfirst.org 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.
EEO Law Poster and Supplement
All hiring and recruitment at Healthfirst is transacted with a valid "@healthfirst.org" email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.