Description and Requirements The Complete Care Specialist is responsible for developing and maintaining relationships, leads, and new business using consultative selling/marketing. This role serves as the key player in educating Medicare Advantage and Medicaid Advantage Plus (MAP) benefits to potential members in a manner that is compliant with Centers for Medicare & Medicaid Services (CMS) and Healthfirst’s policies. The Complete Care Specialist is a pivotal presence in the community and point|of|contact for current members.

The Complete Care Specialist is responsible for developing and maintaining relationships, leads, and new business using consultative selling/marketing. This role serves as the key player in educating Medicare Advantage and Medicaid Advantage Plus (MAP) benefits to potential members in a manner that is compliant with Centers for Medicare & Medicaid Services (CMS) and Healthfirst’s policies. The Complete Care Specialist is a pivotal presence in the community and point-of-contact for current members.

Enrollment Process

Ensure prospective members are enrolled properly and all internal and external processes are followedUsing electronic pen technology ensures that the applications are electronically submittedEnsure that extra documents relative to the applications are faxed and submitted to the Enrollment Department such as, termination letter from another Medicaid Advantage Plan, Durable Power of Attorney, etc.Enter all information into an electronic book of business and supply supporting documentation to all new enrollees (copy of application, Low-income Subsidy (LIS) letter, a summary of benefit, etc.)

Communication, Listening & Speaking

Adjust communication style based on the audience such as, family members, care givers, social workers, colleagues, and anyone that will need to participate on behalf of the member during the sales process

Identify the prospective member(s) comprehension of products and services being discussed through varied techniques

Performance Requirements

Develop and nurture relationships with prospective members, community leaders, owner hospitals, community partners, and current business partners. Must generate referrals to the Medicare Advantage and Medicaid Advantage Plus (MAP) plans to ensure individual enrollment quotas are met based on tenureRequired to attend all Sales Meetings and gatherings. Must submit three reports daily: Plan of Action, Mid-day, and End-of-dayInteract with others in professional situations, sharing useful knowledge, and developing long-term mutually beneficial relationships with others in the organization to maximize benefits to the organizationParticipate and help organize formal and informal networking events, interact with professionals within and across organizations, exchange useful information with coworkers, and develop relationships with key internal stakeholdersAttend multiple networking events (e.g., seminars and conferences) while sharing useful information obtained with other organization members and colleagues collaborating to draw on an existing pool of network resourcesEstablish partnerships with peers to carry out joint marketing efforts of shared sitesStay informed on all recent changes in regulations, recent training sessions, changes in workflow, and changes to Healthfirst’s benefitsAchieve a passing score on post and ongoing quizzes, attend refresher training, and participate in administrative auditsWhen summoned by the Special Investigation Unit (SIU) of Healthfirst, you will be adequately prepared, forthcoming with information and cooperative in answering questions using your electronic Blackberry and/or soft copies if applicableMinimize the number of mistakes in the field and take ownership of miscalculations by learning from itFollow Company, CMS, and state guidelines relative to Complete Care including all enrollment proceduresTake personal responsibility to complete all online training regarding HIPPA, Marketing and Compliance reg

Technology

Must be able to adapt to various software used by Healthfirst, maintain an electronic book of business, research participating providers, and communicate with internal departments via MS Outlook while safeguarding all Company issued equipmentMust keep an open line of communication with Healthfirst Site Development business unit. This will consist of informing any organization that could be a suitable business partner for Healthfirst or any upcoming events you want to attendMust work in a concerted manner with Network Development and communicate with them any providers that we should attempt to recruit. Ensure Network Development Representatives are abreast of any outstanding issues relative to any of our participating providersStay abreast of the changes in the industry and pass a post/ongoing training exam, as well as ensuring your staff are informed of any changes/updates

Minimum Qualifications: 

High School Diploma or GED equivalentMedicaid, Medicare, Commercial Sales, customer service, or retail experienceAccident & Health license

Hiring Range*:

Greater New York City Area (NY, NJ, CT residents): $57,408 - $76,960

All Other Locations (within approved locations): $49,795 - $72,800

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.