JOB DESCRIPTION Job Summary Providessupport for member growth and retention activities including provision of telephonic application assistance for new and existing members seeking to obtain or maintain health care coverage, and confirms information accuracy for eligibility. Provides information to members (i.e. product overviews, premiums, gaps in care, care management, member engagement events, etc.) and assists as needed with resolution of issues, appointment scheduling, outreach to appropriate state entities, and provision of resources. Supports execution of member satisfaction, retention and quality initiatives.
Essential Job Duties
Proactively facilitates outreach to Molina members regarding upcoming recertification with the state/health plan; educates members on processes, qualifications, required documentation, and completes applications and submissions to the state.
• Assists and resolves complex member issues related to application errors, immigration status, multi-family enrollment, premiums, eligibility, etc.
• Manages individual state dashboards.
• Handles inbound member calls.
Facilitates member reminders (i.e. product overviews, premiums, gaps in care, member engagement events etc.).
• Facilitates the closure of at-risk care gaps, schedules appointments, conducts outreach to appropriate state entities, directs members toward available resources and care management opportunities to ensure member satisfaction, retention, and plan quality performance.
• Promotes and increases member enrollments into plan programs.
• Assists members in contacting respective care manager regarding eligibility issues and follow-up with members to ensure follow-through, if allowed by the member’s respective state.
• Conducts outreach to retain members that have been identified as late renewals, post terms and potential disenrollments, and assists and educates members on next steps and required paperwork.
• Accurately and timely documents outreach in appropriate databases.
• Collaborates with leadership team to provide feedback, trends and insights for areas of opportunity for improvement related to technology, processes, people, retention and the member experience.
• Accesses organizational based platforms and tools for the purpose of inputting and outputting data related to documenting member care, status, renewal status, etc.
• Attends and assists with in-person community-based member retention events.
• Assists with in-person renewals, eligibility issues, application updates, submission of paperwork etc.
• Some in office trainings, meetings and field work required based on business/state-specific/contractual needs.
Required Qualifications
At least 2 years of customer service experience, preferably in a call center/health care environment, or equivalent combination of relevant education and experience.
• Strong customer service acumen.
Ability to assess needs and make thoughtful decisions to support members.
• Time-management and organizational skills.
• Ability to work cross-functionally within a highly matrixed organization.
• Effective verbal and written communication skills, and professional telephone etiquette skills.
• Microsoft Office suite/applicable software program(s) proficiency.
• For the state of New York: Certified Application Counselor (CAC) and/or ability to obtain certification within 60 days of hire date.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Originally posted on Himalayas