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About the Role
The State Programs Facilitated Enroller assists individuals with enrollment and renewal applications through the NY State of Health marketplace. This role involves reviewing income documents, assessing eligibility within NYS systems, conducting outreach, and answering questions about CDPHP plans. The position requires adherence to NYS and Federal regulations and CDPHP standards.
Responsibilities
- Assist members in renewing coverage through the NY State Health marketplace.
- Handle inquiries regarding enrollment in the NY State of Health via phone, email, or other correspondence.
- Make outbound calls to gather missing or incomplete information.
- Act as the primary telephone contact for customers regarding enrollment and renewals in State Programs.
- Deliver enrollment verification information, including plan identification card usage, provider network, and prescription programs.
- Assist prospective members with inquiries and enrollment in individual off-exchange health plans directly with CDPHP.
- Maintain outreach standards to support membership growth.
- Utilize and understand systems such as Facets, EMEDNY, InContact, Macess EXP, and NY State of Health.
- Enter enrollment information into Salesforce promptly and maintain accurate notes.
- Perform duties in compliance with corporate and department performance standards.
- Collaborate with team members to achieve accuracy, timeliness, and customer satisfaction goals.
- Assist with inbound calls and schedule enrollment appointments.
- Ensure confidentiality of all data in compliance with policies.
- Communicate State Programs goals and processes effectively.
- Comply with CDPHP’s Corporate Compliance Policy and all related laws, rules, regulations, and standards of conduct.
- Report any suspected violations of law, standards of conduct, or Corporate Compliance Policy.
- Perform other duties as assigned.
- Be available for after-hours events as needed.
Requirements
- High school diploma or GED required.
- Marketplace Facilitated Enroller certification or Certified Application Counselor certification required or must be obtained within 30 days of hire.
- Minimum of 1 year employment experience in a health insurance setting required, with experience in Government Programs preferred.
- Demonstrated ability to interpret and make decisions based on corporate underwriting guidelines, as well as State of New York & Federal statutes relating to healthcare administration.
- Demonstrated ability to proactively identify problems and recommend/implement solutions.
- Demonstrated ability to work with and maintain confidential information.
- Demonstrated ability to provide excellent customer service and develop relationships internally and externally.
- Excellent verbal and written communication skills.
- Flexibility to adapt to a changing and fast-paced environment.
- Strong system research and analysis skills; deductive and creative thinking.
- Strong attention to detail and capability to meet established productivity and quality standards.
- Demonstrated ability to effectively manage time with multiple task assignments.
- Ability to speak Spanish or another language preferable.
Skills
- Customer service
- Verbal communication
- Written communication
- System research
- Analysis
- Deductive thinking
- Creative thinking
- Attention to detail
- Time management
- Multitasking
Location
- Remote
Work Type
- Full-time
Experience Level
- 1 year
Education Level
- High school diploma or GED
- Marketplace Facilitated Enroller certification
- Certified Application Counselor certification
Salary/Compensations
- The salary range indicated in this posting represents the minimum and maximum of the salary range for this position. Actual salary will vary depending on factors including, but not limited to, budget available, prior experience, knowledge, skill and education as they relate to the position’s minimum qualifications, in addition to internal equity. The posted salary range reflects just one component of our total rewards package.
Benefits
- Participation in group health and/or dental insurance
- Retirement plan
- Wellness program
- Paid time away from work
- Paid holidays
About the Company
- CDPHP is a health plan.
Equal Opportunity
- All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.