Retention Spec - SN & Indiv Mkt- 014528

Summary

This telephone position educates and assists with the recertification process for Marketplace health insurance products, including Child Health Plus (CHP), Medicaid Managed Care (MA/MMC), and Essential Plan (EP). This role prepares the incumbent for a Facilitated Enroller position.

Essential Retention Specialist Responsibilities/Accountabilities • Receives incoming calls from our Inside Sales Team for members who have indicated that want assistance with their health insurance recertification.• Reviews family income and household size to determine eligibility for Medicaid/Medicaid Managed Care, Child Health Plus and the Individual Market; to include 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, citizenship 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.• 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, engaging with translation service as needed.• Calculates and compares financial information as is required in the enrollment process, including the ability to interpret tax return information and 3 months financial statements for self-employed applicants.• 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. • Schedules appointments with Marketplace Facilitated Enrollers if they cannot meet in real time with a Retention Specialist.• Answers and/or triages incoming phone calls.• Monitors voice mailbox and returns all voicemail calls.• Backs up team members as appropriate: vacations, last minute appointment schedule changes involving customers, etc. May be required to back up regional MFE in their absence.• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies' mission and values and adhering to the Corporate Code of Conduct.• Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.• Regular and reliable attendance and participation is expected and required.• Performs other functions as assigned by management.

Minimum Qualifications • Bachelor's degree in Sales, Marketing, Business, or related field with a minimum of two years' experience in Marketing, high level Customer Service, or related health insurance area. In lieu of degree, an additional 2 years' experience will be considered.• Obtain New York State MFE training and certification within 30 days of hire.• Strong understanding of Medicaid/Medicaid Managed Care, Child Health Plans and all metal levels of the Individual Market is critical.• Ability to identify and manage enrollment barriers encountered by the applicant and works with the applicant and the Marketplace to resolve enrollment issues.• Bi-Lingual communicator preferred.• 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 evaluate member needs and research a situation to completion. • Ability to work independently without close supervision; be detail oriented and have excellent organizational skills.• Demonstrated understanding of math basic including: adding, subtracting, multiplying, dividing, rounding, and using all units of measure. • Ability to promote safety and good housekeeping for employees within the work area.• Must keep abreast of developments relevant to the function by attendance at meetings, seminars, workshops, etc., and as necessary, independent study.• 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.

Physical Requirements
Normal office environment. Limited day travel required, including quarterly on-site staff meeting and Adhoc organizational / department meetings.

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)