Molina Healthcare
Specialist, Market Growth & Retention (Remote in NY)
Molina Healthcare, New York, New York, us, 10261
Specialist, Market Growth & Retention (Remote in NY)
Job Summary
Provide prospective and existing members with assistance (telephonically inbound and outbound) completing state required applications for the purpose of obtaining and maintaining healthcare coverage, and accurate information for eligibility for Medicaid, CHP and Essential Plan. Provide non-clinical reminders (i.e.; product overviews, premiums, gaps in care, care management, member engagement events etc.) and assist as needed with resolving issues, scheduling appointments, conducting outreach to appropriate State entities and resources to ensure member satisfaction, retention initiatives and quality metrics are met.
Job Duties
Pro-actively facilitate outreach (and handle inbound calls) to Molina members regarding their upcoming recertification with the state and healthplan.
Education and documentation of the required applications and submissions to the State.
Assist and resolve complex member issues related to application errors, immigration status, multi-family enrollment, premiums, eligibility.
Provide non-clinical reminders (i.e. product overviews, premiums, gaps in care, member engagement events).
Facilitate closure of at‑risk care gaps, scheduling appointments, conducting outreach to appropriate State entities and direct toward available resources and care management opportunities to ensure member satisfaction, retention, and quality performance.
Promote and increase member enrollments into plan programs (i.e.; Member portal, Rewards Program, etc.).
Assist Medicaid Members in contacting their social worker regarding eligibility issues and follow‑up with members to ensure follow-through, if allowed by the member’s respective state.
Conduct outreach to retain members identified as late renewals, post terms and potential disenrollments, assist and educate members on next steps and required paperwork.
Accurately and timely documentation of outreach in the appropriate databases.
Collaborate with the leadership team to provide feedback, trends and insights for improvement related to technology, process, people, retention and member experience.
Utilize organizational platforms and tools (Salesforce, CCA, Sharepoint, Excel, Genesys etc.) for data input and reporting related to member care, status, renewal status.
Assist with in‑person community‑based member retention events and possible in‑office trainings, meetings and field work as required.
Maintain appropriate certifications and quality scores in compliance with the State and Molina Healthcare.
Other tasks or special projects as required or directed.
Additional Information
Seniority level
Entry level.
Employment type
Full‑time.
Job function
Sales and Business Development.
Industries
Hospitals and Health Care.
Qualifications
Required education
High School Diploma or equivalent.
Required experience / knowledge
2–4 years customer service experience, preferably in a call center environment; experience communicating with members in a customer service setting and the ability to assess needs and make thoughtful decisions to help a member.
Required license, certification, association
Must have NYS Certified Application Counselor Certification and/or be able to obtain certification within 60 days of hire date.
Preferred education
Associate’s Degree or equivalent combination of education and experience.
Preferred experience
3–5 years customer service experience in a call center environment.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
$16.5 – $38.37 / hourly
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Provide prospective and existing members with assistance (telephonically inbound and outbound) completing state required applications for the purpose of obtaining and maintaining healthcare coverage, and accurate information for eligibility for Medicaid, CHP and Essential Plan. Provide non-clinical reminders (i.e.; product overviews, premiums, gaps in care, care management, member engagement events etc.) and assist as needed with resolving issues, scheduling appointments, conducting outreach to appropriate State entities and resources to ensure member satisfaction, retention initiatives and quality metrics are met.
Job Duties
Pro-actively facilitate outreach (and handle inbound calls) to Molina members regarding their upcoming recertification with the state and healthplan.
Education and documentation of the required applications and submissions to the State.
Assist and resolve complex member issues related to application errors, immigration status, multi-family enrollment, premiums, eligibility.
Provide non-clinical reminders (i.e. product overviews, premiums, gaps in care, member engagement events).
Facilitate closure of at‑risk care gaps, scheduling appointments, conducting outreach to appropriate State entities and direct toward available resources and care management opportunities to ensure member satisfaction, retention, and quality performance.
Promote and increase member enrollments into plan programs (i.e.; Member portal, Rewards Program, etc.).
Assist Medicaid Members in contacting their social worker regarding eligibility issues and follow‑up with members to ensure follow-through, if allowed by the member’s respective state.
Conduct outreach to retain members identified as late renewals, post terms and potential disenrollments, assist and educate members on next steps and required paperwork.
Accurately and timely documentation of outreach in the appropriate databases.
Collaborate with the leadership team to provide feedback, trends and insights for improvement related to technology, process, people, retention and member experience.
Utilize organizational platforms and tools (Salesforce, CCA, Sharepoint, Excel, Genesys etc.) for data input and reporting related to member care, status, renewal status.
Assist with in‑person community‑based member retention events and possible in‑office trainings, meetings and field work as required.
Maintain appropriate certifications and quality scores in compliance with the State and Molina Healthcare.
Other tasks or special projects as required or directed.
Additional Information
Seniority level
Entry level.
Employment type
Full‑time.
Job function
Sales and Business Development.
Industries
Hospitals and Health Care.
Qualifications
Required education
High School Diploma or equivalent.
Required experience / knowledge
2–4 years customer service experience, preferably in a call center environment; experience communicating with members in a customer service setting and the ability to assess needs and make thoughtful decisions to help a member.
Required license, certification, association
Must have NYS Certified Application Counselor Certification and/or be able to obtain certification within 60 days of hire date.
Preferred education
Associate’s Degree or equivalent combination of education and experience.
Preferred experience
3–5 years customer service experience in a call center environment.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range
Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
$16.5 – $38.37 / hourly
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