Broker Services Specialist III

Broker Services Specialist III

Job Category: Provider Relations Department: Product Sales Location: Los Angeles, CA, US, 90017 Position Type: Full Time Salary Range: $60,778.00 (Min.) - $75,950.00 (Mid.) - $91,166.00 (Max.) Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time. Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

Job Summary The Broker Services Specialist III is the Subject Matter Expert (SME) on the day-to-day duties involving collaboration with external business units such as sales operations and compliance, Finance (MPSS) and I.T. Collaborates with Sales & Marketing Data Analysts to provide monthly productivity report to Leadership and identify key metrics for Broker Support Team. This position builds and maintains a positive and professional relationship with L.A. Care's contracted General Agencies (GA) and their contracted Agents and provides training and basic knowledge on L.A. Care and specified lines of business, and is an expert in knowledge on Sales Force and all proprietary systems, procedures and tools. The Broker Services Specialist III serves as the primary Point of Contact with our finance unit to ensure agent sales commissions are reconciled and paid within the pay period. This position is responsible for supporting L.A Care's Direct Agent Service Model (DASM) and being the primary point of contact for agencies participating in the DASM. The DASM provides direct support to agents who will be designated by their members as authorized agents to make payments or make certain changes to their account on their behalf. In addition, this position provides a high degree of customer service to all Management, the Sales Teams and interdepartmentally, to ensure that growth and retention for L.A. Care members and beneficiaries. Acts as a Subject Matter Expert, serves as a resource and mentor for other staff.

Duties

• Customer Relations: Manages the inside support requirements of multiple inquiries from the contracted broker community and manage the operations of L.A Care's DASM. Outcomes Expected: Maintains relationships by answering inquiries from brokers, via Sales Force, telephonic, or any alternate communication. Follows through with timely responses, including research and resolution, as established by department Key Performance Indicator's (KPI) and maintain follow-up with key GA partners who are part of the DASM to ensure all submitted change requests are completed by the Broker Support team in a timely manner. Manages broker profiles in Salesforces to ensure data accuracy. Acts as point of contact for stakeholders and provide updates accordingly to daily/weekly/monthly meetings with leadership. (40%)
• Sales Operations/ Compliance and Regulatory Requirements: Serves as a liaison to Sales Operations and assist with; general agency contracting and agent onboarding, off boarding, transfer request processing for L.A Care Medicare Plus (DSNP), L.A. Care Covered (LACC) and other product lines added. Serves as liaison to Finance (MPSS) for commission reconciliation and payments. Assist with processing of new agent requests, agent inquiries inbox, management of license expirations, generate of appointment agent report for Finance, generate/validate compliance reports for Brokers, Office of Inspector General (OIG) report, agent termination report (LACC), America's Health Insurance Plans (AHIP) tracking and update. Works with internal Sales compliance staff to monitor sales regulations and adherence to State and Federal Marketing guidelines. In addition, works with systems to ensure appropriate data is collected for auditing purposes. Works with IT for testing and implementation of system updates or upgrades. (10%)
• Information Technology: Assists in the development of broker portal enhancements from an Agent perspective internal/external. Researches best practices and supports developing the solutions and recommendations for the current business operations. (10%)
• Communications: Assists in developing advisories in collaboration with the Business Development Program Manager II in order to provide communications related to Open Enrollment, Annual Enrollment Period, product line updates and notices to the General Agencies. Represents L.A Care with Broker and Strategic Partners: Participates in any L.A. Care related functions in support of growth for broker and partners. Outcomes Expected: Maintains relationships with partners by partaking in internal or external event requests. Duties Continued Represents L.A Care's DASM by serving as the liaison with GA partners to ensure all submitted requests are processed on time in order to retain broker partner satisfaction. Manages external communication inquiries from L.A Care's contracted General Agencies via Agent Support inbox, Agent Support call queue and work phone line. Assists in developing advisories in collaboration with the Business Development Program Manager II in order to provide communications related to Open Enrollment, Annual Enrollment Period, product line updates and notices to the General Agencies. (10%)
• Monitor and Track Caseload: Monitors and tracks the progress and outcomes of partnerships through documentation and communication to management. Outcomes Expected: Reviews frequent reports to ensure inquiries are closed out according to Key Performance Indicator (KPI's). Maintain Customer Relationship Management (CRM) tracking of general agency and agent profiles and other key information. Ensures documentation meets standards through regular audits. Maintains communication with management regarding trends of inquiries through daily tracking. Reviews all submitted problem and improvement reports; identifies priority issues; evaluates opportunities for improvement, presents findings to supervisors for evaluation and prepares resolution work plan as directed. Develops and execute test plans. Monitors all solutions through to resolution. Maintains key log of all agents participating in Direct Agent Service Model and ensure all compliance requirements are received and stored. Updates regular reporting on agent inquiries and ensures timely case resolution. (10%)
• Applies subject expertise in evaluating business operations and processes. Identifies areas where technical solutions would improve business performance. Consults across business operations, providing mentorship, and contributing specialized knowledge. Ensures that the facts and details are correct so that the project's/program's deliverable meets the needs of the department, organization and legislation's policies, standards, and best practices. Recommends process improvements, and mentors junior level staff, department interns, etc. as needed. Provides training and onboarding of new hires, and ensuring successful access to all systems needed for the Broker Support Role. In addition, provide mentorship to Broker Support team by providing daily trainings, assistance, and constant communication via emails, meetings (huddles) and WebEx messenger. Create workload inquiries and Delegates to staff. Creates Staff schedules during Open Enrollment/Annual Enrollment Period in order to meet business requirements. Develops desktop level procedures as an SME in order to maintain compliance measures, in addition providing staff with a frame of reference for job duties. (10%)
• Perform other duties as assigned. (10%)

Education Required Associate's Degree in Healthcare Administration or Related Field In lieu of degree, equivalent education and/or experience may be considered. Education Preferred

Experience Required: At least 2 years of experience in a health plan or broker related environment, including but not limited to the following interface of these functions: At least 2 years of experience in Broker Support role and in good standing. Sales outreach and enrollment, Customer service; Project coordination; working knowledge and understanding of production regulations, including Medicare, Medi-Cal and Covered California.

Skills Required: Proven ability to significantly impact process improvement and process management. Ability to document scope, project tasks in a clear and concise manner. Thorough understanding of relevant industry practices, techniques and standards. Must have a comprehensive understanding of business process/ life cycle management principles, theories and concepts. Excellent problem-solving/ analysis/computational skills Proficiency in Microsoft Office applications, database management. Ability to articulate relevant information and directions in an organized and concise manner. Excellent interpersonal, verbal, and written communication skills; Understanding of effective communication concepts tools and techniques. Excellent collaboration skills. Ability to interact successfully with both internal and external customers at all levels. Ability to conform to shifting priorities, demands, and timelines through analytical and problem-solving capabilities. Ability to effectively train onboarding staff through virtual or hands-on approach. Persuasion Skills: Represent Manager in meetings. Demonstrate leadership and interpersonal communication skills by working collaboratively and effectively with peers, superiors and subordinates to accomplish objectives. Able to concisely, clearly and formally communicate complex concepts and formulate process solutions.

Preferred: Knowledge of CRM systems and navigation for contact resolution

Licenses/Certifications Required Medi-Cal and Medicare Training Certification (Or must be obtained within 90 days from date of hire.)

Licenses/Certifications Preferred Life & Health License - Active, current and unrestricted California License within 90 days of hire. America's Health Insurance Plan (AHIP) Medicare Designation and Covered CA Certification (Or must be obtained within 90 days from date of hire.)

Required Training Required: Product trainings - MediCal, L.A. Care Covered, Medicare.