Marketplace Facilitated Enroller I/II - 005899

Summary:

This position educates and assists with the enrollment and recertification process for On and Off Marketplace health insurance products, including Child Health Plus (CHP), Medicaid Managed Care (MA/MMC), Essential Plan (EP) and the Individual Market; Qualified Health Plan (QHP). In addition, this role requires business development/outreach skills geared toward driving education and awareness targeting small businesses, community agencies, groups and events contributing to increased retention and growth in membership. Due to the nature of this role, incumbents must be vaccinated for Covid-19.

Essential Facilitated Enroller Responsibilities/Accountabilities:

All Levels:

Level I:

Outreach

• Establishes trusted relationships, educates on product portfolio and marketing efforts and value add health plan provides within assigned territory:
• Community influencers, local agencies/community events, health fairs, grass roots community-based organizations and efforts
• Proactively reaches out to local businesses within assigned territory to educate and increase awareness of heath care offerings, state regulations and the Excellus/Univera brand.
• Participates in department business strategy sessions; provides input from customer's point of view & competitive intelligence on the street.

Customer Assistor

• Collects/reviews family income and household information used to determine eligibility for above named product portfolio including Adjusted Premium Tax Credit (APTC) and Cost Sharing (CS) for individuals and families.
• Assists individuals and families with securing and providing required documentation to demonstrate age, residency, and income as is required by the Marketplace.
• Communicates health insurance program options, fundamentals of all the health insurance products, benefits, and associated costs based on analysis of the applicant's situation.

• Improves customer retention through on-boarding best practices defined as part of the assistor process. Acts as member advocate for the individual to the Marketplace. Applies the rules and regulations of the marketplace to the individual situation and provides open communication on application process between the parties.

• Reads, interprets and applies the Marketplace Facilitated Enroller (MFE) Training Manual rules and regulations when dealing with current or potential members.

• Communicates application and eligibility requirements in more than one language.

• Calculates and compares financial information as is required in the enrollment process. Included in this requirement is the ability to recognize tax return information and 3 months financial statements for self-employed.

• Interprets a variety of complex instructions from the MFE Training Manual to assist applicants.

• Provides critical assessment and analysis which effects insurance enrollment for families and children.

• Presents all aspects of eligibility, enrollment and available products to community audiences.

• Meets with applicants in locations that have additional MFE resource backup.

• Attends annual NYSDOH regional fall enrollment events, staying abreast of new information for upcoming annual enrollment

• Backs up team members as appropriate: vacations, last minute appointment schedule changes involving customers, outreach events, etc.

• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values, adhering to the Corporate Code of Conduct, and leading to the Lifetime Way values and beliefs.

• Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
• Regular and reliable attendance is expected and required.
• Performs other functions as assigned by management.

Level II (in addition to Level I essential responsibilities/accountabilities):

• Works with management on establishing influential relationships in the community within assigned territory.

• Attends community IPA/Navigator Agency Meetings.

• Represents the company in small/large community-based organization meetings as required/complement or collaboration with Community Engagement Program Manager.

• Lead minimum of one SWOT Priority Team per year; management of the committee charter, members' milestones and meeting all goals in a timely manner.

• Gain Subject Matter Expertise (SME) level in key focus area; develop training curriculum and facilitate workshop for team in conjunction with management team.

• Supervise Intern and/or mentor new hires to team; providing first level problem resolution, share Lifetime way cultural expectations, ensure successful on-boarding and engagement in role.

Minimum Qualifications:

NOTE:

We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities.

All Levels:

Level I:

• High School Diploma plus 1 year experience preferably in MFE, customer service, or sales role. Associate degree preferred.

• New York State MFE training and certification is required within 3 months of hire.

• Ability to work independently without close supervision; be detail oriented and have excellent organizational skills.

• Thorough knowledge of Child Health Plus, Essential Plan, Medicaid/Medicaid Managed Care and the Individual Market (Qualified Health Plans) products.

• Ability to evaluate member needs and research a situation to completion.

• Ability to identify and manage enrollment barriers encountered by the applicant and works with the applicant and the marketplace to resolve enrollment issues.

• Demonstrated ability to present to organizations within the community regarding rules and regulations of the health insurance mandate, the enrollment process and available products.

• Must keep abreast of developments relevant to the function by attendance at meetings, seminars, workshops, etc., and as necessary, independent study.

• Knowledge of MS office, (Word, Excel, Access), Lotus Notes (calendar, email), GoldSNAP client relationship management (CRM) tool and other technical applications as appropriate.

• Must display excellent communication skills and have good member and public contact capabilities.
• Ability to handle confidential information with discretion.
• Ability to utilize "meeting" best practices while facilitating weekly staff meeting on a rolling schedule amongst entire team.
• Ability to promote safety and good housekeeping for employees within the work area.

• Demonstrated understanding of math basic including adding, subtracting, multiplying, dividing, rounding, and using all units of measure.

• Demonstrates poise with non-verbal and verbal forms of communication with culturally diverse populations.

• Demonstrate sensitivity when obtaining required personal and confidential information including social security number, income, household composition, and immigrant status.

• Must have the ability to travel.
• Bi-Lingual communications preferred.

Level II (in addition to Level I essential responsibilities/accountabilities):

• A minimum of two years of experience as MFE, customer service lead or relevant experience.
• MFE Required
• Proven track record of productivity, outreach, and customer satisfaction.
• Subject Matter Expert in Child Health Plus, Medicaid Managed Care, Essential Plan and the Individual Market (Qualified Health Plan) products.

Physical Requirements:

• Normal office environment. Some day travel required, including quarterly on-site staff meeting and Adhoc organizational / department meetings.
• Due to the nature of this role, incumbents must be vaccinated for Covid-19.

The Lifetime Healthcare Companies aims to attract the best talent from diverse socioeconomic, cultural and experiential backgrounds, to diversify our workforce and best reflect the communities we serve.

Our mission is to foster an environment where diversity and inclusion are explicitly recognized as fundamental parts of our organizational culture. We believe that diversity of thought and background drives innovation which enables us to provide leading-edge healthcare insurance and services. With that mission in mind, we recruit the best candidates from all communities, to diversify and strengthen our workforce.

OUR COMPANY CULTURE:

Employees are united by our Lifetime Way Values & Behaviors that include compassion, pride, excellence, innovation and having fun! We aim to be an employer of choice by valuing workforce diversity, innovative thinking, employee development, and by offering competitive compensation and benefits.

In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.

Equal Opportunity Employer

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)