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Sales Representative

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MetroPlus Health PlanNewark, NJ
Full-time
  • About NYC Health + Hospitals
  • MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc.
  • As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus’ network includes over 27,000 primary care providers, specialists and participating clinics.
  • For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
  • The Sales Representative is responsible for educating and assisting qualified individuals with purchasing affordable health insurance coverage and/or obtaining an eligibility determination for coverage in Qualified Health Plans (QHPs) and insurance affordability programs such as Medicaid and Child Health Plus (CHP) through the NY State of Health (MarketPlace).
  • The Sales Representative is responsible for identifying and educating prospective members that do not have health insurance and/or are looking to change coverage as well as assisting existing members with recertification and education of benefits.
  • The Sales Representative is tasked with performing all duties in accordance with the Affordable Care Act (ACA) as well as all other pertinent rules and regulations.
  • This is a field position, so while you may have a preference for a specific area, please note that you may be deployed to a different area, based on the organization's needs.
  • Educate and provide assistance to qualified individuals with applying for coverage through the NY State of Health Marketplace in a Qualified Health Plan (QHP) and insurance affordability programs such as Medicaid and Child Health Plus.
  • Assist consumers/applicants with calling the NY State of Health Customer Services Department for assistance with enrolling and/or providing verification documentation.
  • Conduct public education activities for consumers to raise awareness of available QHPs within the Marketplace.
  • Explain potential eligibility for public/governmental programs, how the federal health insurance premium tax credit and cost-sharing reductions work, and outline potential risk factor, if any, to consumers.
  • Describe the features and benefits of health insurance coverage, including cost-sharing mechanisms like deductibles, co-pays, co-insurance and how these work and/or affect the consumer.
  • Describe the different metal tiers within the Marketplace and how the benefits may change at different tiers based on the consumer’s income.
  • Conduct presentations and participate in ACA forums and workshops upon request.
  • Assist consumers with submitting documents and information as required by the Marketplace via scan, fax or mail.
  • Assist existing members with recertification, when applicable.
  • Assist consumers with the submission of premium payments when required.
  • Securing and safeguarding confidential information to prevent Protected Health Information (PHI) from being obtained from unauthorized personnel to ensure compliance with privacy and security standards.
  • Provide information in a manner that is culturally and linguistically appropriate to the needs of the population being served by the Marketplace.
  • Participate in all trainings, updates and webinars and other forums in which information is necessary to carry out roles and responsibilities.
  • Mandated to meet the annual MFE recertification requirements.
  • Keep abreast of all industry and regulatory updates as it pertains to the ACA and Marketplace.
  • Maintain discretion regarding business-related files, reports and conversations within the provisions of applicable State and Federal Statutes and regulations.
  • Maintain a daily tracking tool that entails detailed rep activity.
  • Monitor all applications in personal dashboard to ensure timely and accurate follow through from applicants.
  • Conduct a daily review of personal dashboard to address and follow-up on any and/or all potential leads for consumers seeking assistance.
  • Maintain a consistent supply of various educational and product line collateral.
  • Keep abreast of all the Marketplace functionalities to effectively manage individual accounts.
  • Conduct a daily review of the MetroPlus “Marketplus” lead management program to follow-up on all new potential enrollment leads and consumer inquiries.
  • Record all follow-up dispositions in a timely and accurate manner.
  • Data enter all applicant demographic, enrollment site and PCP selection data in the required “Enrollment Program” within the MetroPlus portal at the time of the initial enrollment encounter.
  • All other tasks and responsibilities as may be required to satisfy the expectations of the role.
  • Must have a High School Diploma or GED.
  • Minimum of two (2) years of Sales/Customer Relations experience required.
  • Public Speaking experience.
  • Must be in compliance with all conflict-of-interest standards and regulations.
  • Required to work evenings and weekends.
  • Russian speaking language preferred
  • Licensure and/or Certification Required
  • Must complete and pass the NY State of Health approved training program and become certified.
  • Must complete all required annual recertification as a MFE
  • Integrity and Trust

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