Managed Care Membership and Recertification Representative
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Job Description:
Educating prospective and existing enrollees on all aspects of the Plan, as well as answering questions regarding Plan?s features and benefits
• Maintain a clear understanding of covered benefits and services offered by company
• Facilitate new enrollment by assisting prospective members with the application process required to enroll into Company?s plan. This includes conducting individual presentations on Company?s special needs plan and services
• Assist prospective enrollees in the selection of a Primary Care Provider (PCP) and advise them on how to change PCP if needed
• Conduct outreach to existing members to assist with the recertification processes, including personalized visits for those who need it
• Respond to all inquiries regarding the application and renewal process from both new and existing members
• Assist Company members, by answering questions and/or directing inquiries to Member Services as needed
• Establish and maintain a positive working relationship with on-site staff at provider sites and community based organizations
• Document all field activity in a timely manner, through established processes and protocols
• Participate in Company marketing events as assigned
• Ensure that field activities are performed in compliance with all regulatory and corporate policies
• Represent Company to providers, CBOs, members and prospective members in a professional, engaged and enthusiastic manner

email resumes to or fax to 646-459-2177

Experience Level:

• Must be NY State of Health certified Navigator/ Assistor.
• High School Diploma or equivalent required. College degree preferred or an equivalent combination of education and relevant work experience.
• Minimum of 3 years? experience working in the field for a health plan or managed organization
• Proficiency in Microsoft Office (word, Excel, Access, PowerPoint and Outlook).
• Knowledge and/or experience with Medicaid/ Public Assistance preferred.
• Demonstrate understanding and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts
• Ability to travel and work in all five boroughs of New York City. Must be able to work flexible schedule as needed.

email resumes to or fax to 646-459-2177

New York NY

Contract to Direct

Pay Rate:

Date Posted: 05/02/2017
Last Updated: 05/02/2017