Summary of Position
- Responsible for inbound/outbound call activity generating enrollments and renewals for Medicaid QHP, EP, Medicaid & Child Health Plus membership.
- Participate in engagement events to reach members via organization and health related events in the community.
- Resolve member issues impeding renewal or enrollment as well as general member assistance.
Principal Accountabilities
- Responsible for making outbound calls to previous/current QHP, EP, Medicaid & Child Health Plus membership due to special projects, and renewal on a telephonic approach.
- Receive inbound calls directly from members/prospects or transfers from member services.
- Educate and respond to inquiries from members about plan benefits, enrollment, and renewal options.
- Present to, follow up and sell Individual Medicaid, Essential Plan, QHP and CHP products on a direct sales basis.
- Assist and enroll individuals by completing the appropriate application forms, obtain required documentation necessary for enrollment, and meeting necessary enrollment targets. Assist individuals by completing the appropriate forms and/or renewal applications for NYSOH or LDSS (via phone or direct basis).
- Function as a liaison between all EmblemHealth departments to help identify and capture prospect's issue resolution or concerns. Work with Neighborhood Care and HUB (member services) teams to maintain and improve Emblem Health's image as a High Quality and Affordable health plan in the community.
- Maintain appointments, develop community marketing sites, establish relationships with community-based organizations, participate in health-related activities / special events including in person evening and weekend activities, create self-generated leads, and provide services to onsite walk-ins.
- Obtain feedback from referral sources and prospective enrollees.
- Assist QHP, EP, Medicaid & Child Health Plus members with billing inquiries, enrollment inquiries and PCP assignments.
- Utilize automated tools such as Avaya, Facets, SalesForce, Sales Cloud, Service Cloud & ePACES to perform daily duties and conduct telephonic outreach when necessary.
- Develop and maintain appropriate understanding of the health care products related to job functions.
Qualifications
- High School Diploma.
- Driver's License and automobile with appropriate coverage is required for territories - Long Island, etc. preferred.
- Successful completion of annual product training and testing to maintain regulatory certification required.
- 2+ years of relevant, professional work experience required.
- Ability and willingness to travel in the New York metropolitan area required.
- Ability and willingness to work nights and weekends as required required.
- Bi-lingual ability: English and at least one other language: Spanish/Chinese/Hindi/Urdu/Punjaby/Bengali/Russian required.
- Excellent communication skills (verbal, written, presentation, interpersonal) required.
- Ability to organize, prioritize, and successfully manage multiple tasks and priorities simultaneously required.
- Ability to develop strong relationships and influences in the community required.
- Proficient with MS Office (Word, Excel, Powerpoint, Teams, Outlook, etc.); and the ability to enter/update databases required.
- Ability to work independently required.
- Ability to produce Self-Generated leads required.
Additional Information
- Requisition ID: 1000002190_02
- Hiring Range: $27.48-$32.97 per hour
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EmblemHealth
Jul 17, 2025