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Healthfirst

State Program Member Engagement Specialist (RS)

New York, NY

Working in Brooklyn, the Retention Specialist is responsible for retaining existing Medicaid, Child Health Plus (CHP), Essential Plan (EP) 1 & 2 and Qualified Health Plan (QHP) members. Incumbent must demonstrate a proven ability to use and operate a laptop and other technical devices; working knowledge of Microsoft Office environment.

  • Responsible for assisting current members who are due to recertify their healthcare coverage for Medicaid, EP 1&2, QHP and CHP by completing member's annual recertification application including any additional eligible family members through the NYSOH marketplace or HRA/LDSS.
  • 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. BOB entries should be updated via Saleslogix (SLX) and daily results via the PHSP Tracker tool.
  • Successfully meet pre and post training and regulatory exams and audit requirements.
  • 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.
  • 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.
  • Additional duties as assigned.

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Minimum Qualifications

  • Ability to travel to the 5 boroughs in NYC and Long Island in some boroughs you might need a car
  • High School Diploma or GED from an accredited program
  • Previous telemarketing, customer service, field sales, insurance or any other relatable sales experience
  • Ability to work in indoor and outdoor environments during all four seasons
  • Ability to work flexible hours including evening and weekends as needed
  • Fluency in English and Creole; South Asian; Russian; and/or Spanish

NOTE: To perform this job successfully, an individual must pass pre-employment testing, Facilitated Enrollment training and demonstrate a proven ability to use and operate a laptop and other technical devices; working knowledge of Microsoft Office environment. Data entry skills type 20 WPM with 90% accuracy.

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Preferred Qualifications:

  • Ability to work in a fast paced environment
  • Ability to work in a changing environment
  • Ability to work in indoor and outdoor environment
  • Responsible for assisting current members who are due to recertify their healthcare coverage for Medicaid, EP 1&2, QHP and CHP by completing member's annual recertification application including any additional eligible family members through the NYSOH marketplace or HRA/LDSS.
  • 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. BOB entries should be updated via Saleslogix (SLX) and daily results via the PHSP Tracker tool.
  • Successfully meet pre and post training and regulatory exams and audit requirements.
  • 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.
  • 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.
  • Additional duties as assigned.

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.

Hiring Range:

  • Greater New York City Area (NY, NJ, CT residents): $56,000 - $74,880
  • All Other Locations (within approved locations): $48,600 - $70,720

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.

Client-provided location(s): Brooklyn, NY, USA
Job ID: healthfirst-R016270
Employment Type: Other

Perks and Benefits

  • Health and Wellness

    • Health Insurance
    • Health Reimbursement Account
    • Dental Insurance
    • Vision Insurance
    • Life Insurance
    • Short-Term Disability
    • Long-Term Disability
    • FSA
    • HSA
    • Fitness Subsidies
    • Mental Health Benefits
    • Pet Insurance
  • Parental Benefits

    • Birth Parent or Maternity Leave
    • Family Support Resources
  • Work Flexibility

    • Remote Work Opportunities
    • Hybrid Work Opportunities
  • Office Life and Perks

    • Commuter Benefits Program
    • Casual Dress
    • Happy Hours
    • Company Outings
    • Holiday Events
  • Vacation and Time Off

    • Paid Vacation
    • Paid Holidays
    • Personal/Sick Days
    • Volunteer Time Off
  • Financial and Retirement

    • 401(K) With Company Matching
    • Performance Bonus
  • Professional Development

    • Internship Program
    • Tuition Reimbursement
    • Promote From Within
    • Access to Online Courses
    • Lunch and Learns
    • Associate or Rotational Training Program
    • Learning and Development Stipend
  • Diversity and Inclusion

    • Employee Resource Groups (ERG)
    • Woman founded/led
    • Diversity, Equity, and Inclusion Program

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