State Programs Member Engagement Specialist (Facilitated Enrollment)

Overview The MarketPlace Facilitated Enroller is responsible for identifying and educating potential members on all aspects of the plan including new Medicaid, CHP/EP/QHP and answering questions regarding plan’s features and benefits. Responsibilities Identify and assist current members who are due to recertify their healthcare coverage for Medicaid, EP, QHP and CHP by completing member’s annual recertification application, including adding eligible family members. Engage in enrollment activities over the phone or in person through onsite coverage at hospitals, provider offices, City agencies, community business partners and Community Based Organizations (CBOs). Complete and review all applications before submitting them to the NYSOH marketplace. Assist members with selecting a high‑quality Primary Care Physician (PCP), ordering member ID cards, and handling monthly premium payments. Use the Healthfirst provider directory and provider search tool; verify information in Salesforce, Member360, OnContact, and BizTalk before making any member‑requested changes. Manage inbound and outbound telephonic enrollment processes as part of the sales enrollment. Occasionally perform enrollment functions remotely in compliance with the telecommuting policy. Educate members about digital tools including the HF mobile application, Twilio, and NowPow Maintain, and complete an adequate Book of Business (BOB) for all encounters and leads daily, adhering to BOB policies and procedures. Conduct group educational seminars and presentations on Healthfirst products, services, and preventive care, both in person and virtually. Participate in health‑related activities and special events such as health fairs, parades, holiday theme events, trade show expos, hospital orientations, provider‑sponsored events, and weekend activities as required by business needs. Establish and maintain strong relationships with external partners—including hospitals, provider organizations, City agencies, small businesses, and Community Based Organization personnel—to facilitate enrollment activities. Develop and strengthen relations to generate new opportunities for Healthfirst, including new sites and event requisitions. Maintain current knowledge of product benefits, formulary, sales system functionality, policies, and procedures. Demonstrate working knowledge of regulatory and corporate guidelines and stay current with changes to all lines of business to ensure compliant sales practices. Follow protocols and guidelines from the sales auditing department regarding schedule and site changes. Maintain an adequate supply of marketing materials required for recertification applications. Arrive on time at scheduled work sites and event locations in accordance with departmental attendance policy. Participate in staff meetings, one‑on‑one management meetings, and required training sessions. Pass pre‑ and post‑training, regulatory exams, and audit requirements. Complete the annual NYSOH marketplace recertification requirement, annual corporate compliance and sexual harassment training, and any required training from the City Department of Health (CDOH) or Human Resources Administration (HRA). Understand and implement the plan’s policies and procedures for facilitated enrollment and renewal. Provide management with information on opportunities at current or potential marketing sites. Stay informed of competitor products and marketing practices and report findings to management. Raise concerns or issues about site coverage, competition, or training needs, and recommend process improvements to increase workflow efficiency. Minimum Qualifications Knowledge of Medicaid, Essential Plan, Child Health Plus, Qualified Health Plan, Medicare, or any other healthcare product line. Basic knowledge of Microsoft Office (Excel, Word, and PowerPoint). GED or high school diploma required. Preferred Qualifications Associate or Bachelor’s degree. Bilingual preferred. Benefits Hiring Range: Greater New York City Area (NY, NJ, CT residents): $58,900 - $80,070 All other locations (within approved areas): $51,000 - $74,880 Healthfirst offers employees a full range of benefits including medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401(k) contributions. All benefits are subject to eligibility requirements. Equal Opportunity Employment Statement 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 Disabilities 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. #J-18808-Ljbffr Healthfirst