Marketplace Facilitated Enroller I/II (Greater Rochester Territory)

Job Location This role is open exclusively to candidates who currently reside in the greater Rochester area (Monroe, Seneca, Yates and Livingston counties). Summary The Marketplace Facilitated Enroller (MFE) identifies prospective members who have no health insurance and educates them about On- and Off-Marketplace health insurance products, assists in selecting the appropriate health plan and primary care physician, and supports the enrollment process. The MFE also helps current members with plan recertification, covering products such as Child Health Plus, Medicaid Managed Care, Essential Plan, Stand Alone Dental and the Individual Market Qualified Health Plan. Essential Accountabilities – Level I Conducts interviews and screens potentially eligible recipients for enrollment into an appropriate health insurance program/product. Communicates and reviews health insurance program options, benefits, and associated costs based on analysis of the applicant’s eligibility. Meets with prospects at various sites throughout the communities, including in-home as needed. Provides critical assessment and analysis that affects insurance enrollment for families and children. Collects and reviews family income and household information used to determine eligibility for the product portfolio including APTC and cost sharing for individuals and families. Assists individuals and families with securing and providing required documentation to demonstrate age, residency, and income. Identifies and manages enrollment barriers and works with the applicant(s) and the marketplace to resolve enrollment issues. Reviews all applications for completeness and accuracy prior to submitting to the marketplace. 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 eligibility and provides open communication on the application process. Proactively reaches out to local businesses and community agencies/groups within the assigned territory to educate and increase awareness of healthcare offerings, state regulations, and the health-plan brand. Participates in on-site enrollment opportunities (hospitals, community centers, etc.) and health-related activities or special events within the assigned territory, including evening and weekend activities. Participates in NYSDOH regional fall enrollment events and stays abreast of new information for upcoming annual enrollment. Participates in department business strategy sessions, providing customer-point-of-view input and competitive intelligence. Recommends process improvement and advises management of proposed recommendations that can make a workflow or process more efficient. Consistently demonstrates high standards of integrity by supporting the company’s mission and values, adhering to the corporate code of conduct, and living the company’s core values. Maintains high regard for member privacy in accordance with corporate privacy policies and procedures. Performs other functions as assigned by management. Essential Accountabilities – Level II Represents the company in community-based organization meetings as required or in collaboration with the Community Engagement Program Manager. Leads a minimum of one priority project per year: manages the committee charter, members’ milestones, and meets all goals in a timely manner. Supervises interns and/or mentors new hires providing first-level problem resolution. Shares cultural expectations and ensures successful onboarding and engagement in the role. Minimum Qualifications – Level I High School Diploma or equivalent with three or more years of experience in MFE, customer service, sales or a related area. Experience working for a health insurance company preferred. New York State MFE training and certification required within 3 months of hire. Demonstrated knowledge of Child Health Plus, Essential Plan, Medicaid/Medicaid Managed Care, Stand Alone Dental and the Individual Market (Qualified Health Plans) products. Ability to present to organizations within the community regarding rules and regulations of the health-insurance mandate, the enrollment process, and available products. Ability to communicate with a diverse clientele in a compassionate, fair, and accurate manner. Bilingual preferred. Excellent written and oral communication skills. Strong attention to detail and capability to meet established productivity and quality standards. Proficiency with Microsoft Word, Excel, and PowerPoint. Familiarity with GoldSNAP client relationship management (CRM) tool and other technical applications. Minimum Qualifications – Level II Four or more years of experience as MFE, customer service lead, sales or relevant experience. Thorough knowledge of the product portfolio listed above. Completed Employee Development Plan. Physical Requirements Ability to work while sitting and/or standing at a workstation viewing a computer and using a keyboard, mouse and/or phone for three or more hours at a time; ability to hear, understand, and speak clearly for interviewing and presentation purposes; ability to travel across the health-plan service region for interviews, meetings and/or trainings as needed; must have a valid driver's license with no restrictions and reliable transportation; ability to lift and transport heavy promotional materials; stand for continuous periods in all weather conditions. Equal Opportunity Employer In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Compensation Range Minimum: $62,400 - Maximum: $84,000. Actual salary will vary depending on factors such as budget, prior experience, knowledge, skill, and education, as they relate to the position’s minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of the total rewards package, which may also include group health and/or dental insurance, retirement plan, wellness program, paid time away from work, and paid holidays. #J-18808-Ljbffr