Our client, a Health Insurance company, is looking for a Marketplace Enroller for their New Hartford, CT location.
Responsibilities:
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.
Out reach All Levels 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 effort so Proactively reaches out to local businesses within assigned territory to educate and increase awareness of heath care offerings, state regulations and the Client/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
Requirements:
All Levels- High School Diploma plus 1-2 year experience preferably in MFE, customer service, or sales role. Associate’s 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), Gold SNAP 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
Bi-Lingual communications preferred
Physical Requirements:
In support of the Americans with Disabilities Act, this resource requirements document lists only those responsibilities and qualifications deemed essential to the position