Enrollment and Recertification Specialist

Amida Care is a Diversity, Equity, and Inclusion employer committed to full inclusion and elimination of discrimination in all its forms. We strive to develop, promote, and sustain a culture that values equity and leverages diversity and inclusiveness in all that we do.

The position is responsible for assisting prospective members with enrolling into Amida Care’s Special Needs Plan, and assisting current members with their Medicaid recertification applications by phone and in-person as needed. They serve as a subject matter expert for Amida Care’s Managed Care Plan and Services; and, responsible for closing of enrollment leads. This position includes both in-house and external outreach efforts to current and prospective members as directed.

ESSENTIAL FUNCTIONS
Essential functions are job duties and responsibilities that must be performed to accomplish the purpose/ goals of the job.

• Outreach prospective members received as a lead and /or other sources defined by management.
• Educate and assist prospective members with the enrollment in the Amida Care plan in accordance with the New York State Marketplace guidelines, via phone or in person, as directed.
• Attend member and community events as needed. This includes events held during non-traditional work hours and weekends.
• Conduct outreach calls to existing members to assist with recertification process based on departmental protocols, to achieve weekly and monthly productivity goals.
• Explain benefits and services offered by Amida Care as requested or needed when assisting members with recertification.
• Conduct off site visits for members who need and/or request assistance with recertifying, including working on Amida Care’s Recreational Vehicles (RV), when directed.
• Accurately document all member recertification, and enrollments via designated tools including Salesforce, email, and other tools as assigned by management.

OTHER RESPONSIBILITIES
Include other significant responsibilities needed to accomplish job purpose/goals that are performed on a daily or infrequent basis.

• Ensure that all recertification, enrollment and field activities are performed in compliance with Medicaid regulations and corporate policies
• Perform all activities in a timely, effective, and efficient way to sustain membership.
• Maintain required equipment/ supplies as needed and in working order (i.e. business cards, laptop, brochures etc.).
• Report and address issues with laptops, phones and other tools immediately, within an hour of discovering issue.
• Report all incidences, including those immediately resolved and those requiring investigation and follow-up management based on established protocols.
• Perform other duties as assigned.

MINIMUM JOB REQUIREMENTS

• High School Diploma and /or 4 years of relevant work experience
• Completion of Certified Application Counselor Training (CAC) (within two months of hire) with New York State of Health Marketplace and subsequent completion of annual CAC Training; Certified CAC’s required.
• Must be able to work nights and weekends as required
• Must be able to travel and work in all five boroughs of New York City as needed.
• Must be able to work flexible schedule as needed.
• Excellent interpersonal and presentation skills, multi task.
• Demonstrate computer proficiency in Microsoft Office (Word, Excel, Access, and PowerPoint).
• Exhibit ability to learn and work with user-centric electronic systems and tools including a laptop and mobile phone
• Demonstrate understanding and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts.
• Demonstrate appropriate behaviors in accordance with the organization’s vision, mission, and values.

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