Bilingual Call Center Representative

The Relationship Coordinator solicits and provides information via telephonic efforts in support of Healthfirst's Medicare Advantage Plan, Complete Care (MAP), Managed Long Term Care Plan (MLTC) Senior Health Partners (SHP) and Mainstream/Health and Recovery Plan (HARP) population seeking PCA and/or CDPAS services. This position ensures that referral sources, prospective enrollees and/or family members are courteously, appropriately, and effectively educated on the Long-Term Care enrollment processed through communication and follow-up and clearly articulate each product line to prospective clients. In addition, the Relationship Coordinator understands how Healthfirst goals relate to sales performance and meet established quotas. Integrated Products is a paperless, call center work environment requiring daily hands-on administration of multiple electronic Patient Health Information (PHI) databases and security requirement tools such as encryption. These systems include, but are not limited to, Salesforce, RightFax, Virtual Work Platforms (using VPN), SharePoint Sites, TruCare and MS Office 365 software (such as Word and Outlook). Duties and Responsibilities Handling inbound and outbound calls to and from customers to address their needs while adhering to internal Service Levels standards. Creates and/or follow ups for up to 90 days on Long-Term Care (LTC) Leads and Opportunities entered in Salesforce. Create and/or follow ups for up to 30 days on Personal Care services requests for the Mainstream population in Salesforce. Answer all calls or complete outbound calls according to approved scripts. Searches ePACEs for Medicaid eligibility, exclusion, and exemption codes. Searches in Marx (CMS) for Medicare eligibility, enrollments, and special elections. Achieves daily, weekly, and monthly growth goals. Handle all calls to maximize productivity and optimal operational efficiency. Connects consumers seeking personal care/long term care services with the State broker to complete the initial evaluation. Schedules all field and tele video conference appointments for SHP Intake Nurses in Salesforce. Schedules all field and tele video conference appointments for HF CompleteCare Specialist and Intake Nurses in Salesforce. Schedules Entitlement Advocates appointments for SHP and HF Complete Care prospective members with a Medicaid coverage issue or restriction. Schedules Clinical Assessors to complete Community Health Assessments for Mainstream/HARP members requesting Personal Care Services at home. Documents all incoming/outbound calls under call tracking in Salesforce Documents all outcomes in pre-enrollment database system. Documents all special instructions in Salesforce Coordinates the preparation of fulfillment kits / brochures to prospective members or those requesting addition information in a timely manner. Troubleshoots and follows up on LTC enrollment rejections. Handles other duties as assigned with the occasional need to work weekends, additional hours before or after shift scheduled. Engage in mastering the Divisions impact on all Healthfirst Plans and its members. Ability to create a positive impression during first contact with prospective members by setting the tone and being able to immediately demonstrate product knowledge and credibility with the goal of maximizing the number of scheduled appointments to achieve daily, weekly, and monthly goals. Persuasive and able to establish trust. Additional duties as assigned. Minimum Qualifications High school diploma or GED. Fluency in reading and speaking English and Spanish Member / Customer Service experience. Availability to work for 8 ½ hours shift, based on business needs, within our hours of operations: Monday – Friday 8:00 AM – 8:00 PM and Saturdays 10:00 AM – 6:30 PM. 8:00 AM to 8:00 PM Monday -Sunday during open enrollment (October – March). Initial Training schedule may vary from permanent assigned schedule. Occasional overtime. Capability to work in a remote environment with reliable internet connection. Tech Savvy computer skills such as Microsoft Office Suites: Outlook, Excel, Word, PowerPoint Organized and multi-tasking capabilities and detail oriented. Understanding of and sensitivity to cultural differences and needs of the community are essential. Adept at working in an environment with fast-past changing priorities including high stress while achieving quota expectations. Available to communicate / engage with your leaders via Virtual platforms (emails, MS Teams and others) Preferred Qualifications Work experience within the healthcare industry Experience with Medicare or Medicaid managed care plan products such as, Family Health Plus (FHP), Eastern Benefits System (EBS) and/or Federal Employee Program (FEP). (Preferred) Associate degree or higher from an accredited institution. Extensive work experience including inbound and outbound call center with telemarketing responsibilities within a healthcare environment. Healthfirst product knowledge of Complete Care, Senior Health Partners (SHP) or managed long-term care. Prior experience engaging / communicating with the frail adult or elderly population. A solid understanding of the value of integrated care. Experience in health insurance, home care environment, acute, sub-acute, long-term care (LTC) setting or managed-long term care (MLTCP). Experience managing member information or appointments in a shared network environment using paperless database modules. Adept at operating within a multi-cultural work environment and community of Members such as Spanish, Chinese, Southeast Asian and others. Ability to maintain a calm, neutral disposition while managing many details in a distracting environment. WE ARE AN EQUAL OPPORTUNITY EMPLOYER HF Management Services, LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender and/or gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, as well as any other legally protected basis. HF Management Services, LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified. 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 View email address on click.appcast.io or calling View phone number on click.appcast.io . 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 HF Management Services, LLC will be reviewed at the email address and phone number supplied. Know Your Rights 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): $48,600 - $65,960 All Other Locations (within approved locations): $42,200 - $62,400 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. Benefits and Compensation 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. Company Culture Healthfirst is New York’s largest not-for-profit health insurer offering it’s nearly 1.7 million members access to high-quality, affordable healthcare. As part of the community for nearly 30 years, Healthfirst’s unique advantage is rooted in its belief that good health doesn’t start in a doctor’s office. The company’s mission is to put its members first by working closely with care providers and community leaders to address broader issues that can impact health and well‑being. This value-based care model is the foundation of the company’s sustained growth in one of the most dynamic markets in the country. So, if you are passionate about what you do and want to work for a company that is focused on the future and dedicated to making a difference in people’s lives, then Healthfirst is for you. #J-18808-Ljbffr Healthfirst