Call-in/On-Call Enrollment Specialist III

Call-in/On-Call Enrollment Specialist III

This is an as-needed, call-in/on-call position - Bilingual fluency in Spanish.

The Call-in/On-Call Enrollment Specialist III supports health plan enrollment by handling inbound calls and assisting members, employer groups, and partners with enrollment and eligibility needs as business demands require. This role requires bilingual fluency in Spanish and experience managing business-to-business relationships. Prior experience with health plan enrollment is a strong plus, along with strong communication skills, attention to detail, and a high level of customer service.

Work location is remote (e.g. home address), per Kaiser Permanente-s Authorized States Policy - Employees may be required to travel to a Kaiser Permanente or customer sites. Residency required in the primary location:

10990 S.D. Mission Rd., San Diego, San Diego 92108

Job Summary: In addition to the responsibilities listed above, this position is also responsible for attending employer, community, and open enrollment events on an on-call basis to educate members and prospects on KP products; delivering formal presentations to employees and prospective members; independently monitoring and reporting on enrollment performance data and discrepancies; serving as an informational resource for sales and account management teams on KP health plans and benefit offerings when working with customers, internal departments and/or brokers; utilizing comprehensive foundational knowledge of KP health plans and benefit offerings to facilitate formal, stand-up presentations to prospective members; and resolving customers standard and non-standard questions and concerns about benefits and services.

Essential Responsibilities:

• Pursues effective relationships with others by proactively providing resources, information, advice, and expertise with coworkers and members. Listens to, seeks, and addresses performance feedback; provides mentoring to team members. Pursues self-development; creates plans and takes action to capitalize on strengths and develop weaknesses; influences others through technical explanations and examples. Adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; helps others adapt to new tasks and processes. Supports and responds to the needs of others to support a business outcome.
• Completes work assignments autonomously by applying up-to-date expertise in subject area to generate creative solutions; ensures all procedures and policies are followed; leverages an understanding of data and resources to support projects or initiatives. Collaborates cross-functionally to solve business problems; escalates issues or risks as appropriate; communicates progress and information. Supports, identifies, and monitors priorities, deadlines, and expectations. Identifies, speaks up, and implements ways to address improvement opportunities for team.
• Contributes to a positive customer experience by: implementing standard and non-standard protocols to build new and leverage existing relationships with brokers, channels and customers to demonstrate value and build commitment independently; gathering data on standard and non-standard customer needs, and identifying solutions linking KP mission, vision and values, key quality measures, key care management initiatives, and current services initiatives independently; utilizing comprehensive foundational knowledge of product, service, and ratings to respond to, encourage, and educate customers, brokers, and consultants about added services and product enhancements in standard and non-standard situations; and identifying and escalating service failure trends or process improvement opportunities to team and managers to better meet customer needs.
• Facilitates the enrollment and implementation process by: conducting local and regional enrollment meetings to win new and retain current customers; applying standard and non-standard protocols to serve as an advocate for customer needs during the membership enrollment and implementation process independently; and supporting efforts across teams in the overall implementation or renewal process of health plan membership, including research, presentation, preparation, reporting and training coordination independently.
• Contributes to the development of sales strategy by: designing plans for new products, benefits offerings, or pricing models to address customer needs independently; utilizing comprehensive foundational knowledge of health care market to analyze industry trends, and competitor products, offerings, and pricing models to provide lessons learned and strategic recommendations independently; executing an account plan to meet standard and non-standard business objectives for membership, revenue and margin; collecting and analyzing performance data to inform account strategy and identify and escalate potential issues; and utilizing marketing and technical resources to achieve account plan objectives.
• Contributes to sales goal attainment by: collaborating with the team to find new opportunities to grow customer base to new or growing markets; maintaining the prospect database and targeted prospect profiles to inform strategic planning; collaborating within the team to contribute to product and plan design, quote, and Request for Proposal (RFP); providing standard and non-standard recommendations to the team to inform forecasting and pricing independently; and implementing standard and non-standard protocols to increase cross-sell and up-sell opportunities.

Knowledge, Skills and Abilities: (Core)

• Ambiguity/Uncertainty Management
• Attention to Detail
• Business Knowledge
• Communication
• Critical Thinking
• Cross-Group Collaboration
• Decision Making
• Dependability
• Diversity, Equity, and Inclusion Support
• Drives Results
• Facilitation Skills
• Health Care Industry
• Influencing Others
• Integrity
• Learning Agility
• Organizational Savvy
• Problem Solving
• Short- and Long-term Learning & Recall
• Teamwork
• Topic-Specific Communication

Knowledge, Skills and Abilities: (Functional)

• Corporate Partnerships
• Storytelling
• Benefits/Services
• Benefits/Services Presentations
• Brand Strategy
• Business Development
• Business Planning
• Business Process Improvement
• Clinical Selling Expertise
• Commercial Marketing
• Compliance Management
• Creativity
• Data Entry
• Event Planning
• Goal Setting
• Interpersonal Skills
• Member Service
• Negotiation
• Product Strategy
• Sales Operations
• Sales Opportunity Orchestration
• Sales Performance Data
• Sales/Partnership Strategy and Techniques

Minimum Qualifications:

• Bachelors degree in Marketing, Finance, Business Administration, or related degree AND two (2) years of experience in marketing, business development, managing business-to-business relationships, or directly related field OR minimum five (5) years of experience in marketing, business development, managing business-to-business relationships, or a directly related field.

Additional Requirements:

• Bilingual (English/Spanish) Level I required.

Preferred Qualifications:

• Two (2) years of experience in the health insurance industry.
• Two (2) years of experience in health plan enrollment or a directly related field.

Notes:

• Must successfully pass or have passed the bilingual test (within the last 12 months), or be active in the QBS program.