MAP Sales Representative II - NYS Life, Accident and Health License Required

Job Ref: TE0185
Category: Sales
Department: FACILITATED ENROLLMENT
Location: 50 Water Street, 7th Floor, New York, NY 10004
Job Type: Regular
Employment Type: Full-Time
Work Arrangement: Field
Salary Range: $65,592.00 - $65,592.00

Position Overview

Empower. Unite. Care.

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

The Medicaid Advantage Plus (MAP) Sales Representative II provides access to MAP insurance, by providing education and assistance to dual-eligible Medicaid and Medicare long-term care recipients. The MAP Sales Representative III provides education on Medicaid Advantage Plus features and benefits to consumers, providers, and business partners.

Scope of Role & Responsibilities 

• Educate and enroll dual-eligible Medicaid and Medicare consumers for the MetroPlusHealth Medicaid Advantage Plus (MAP) product.
• Identify dual-eligible Medicaid and Medicare consumers via Home Care Agencies, Adult Day Care Centers, DME Provider offices, Caregiver Resources Centers, specialty provider offices, HHC Long-Term Care Facilities, etc.
• Understand and apply all policies and procedures pertaining to:
  • Disclosures and provisions of the various MetroPlusHealth Plan products.
  • Enrollment and disenrollment for the MAP line of business.
  • Complete enrollment calls and workflows resulting in smooth initial and plan-to-plan transfers
• Remain knowledgeable of services available and utilized by dual-eligible Medicaid and Medicare consumers eligible for MAP, i.e., State benefits, rehabilitation therapies, personal care, chore services and housekeeping, social adult day care, dental care, etc.
• Responsible for understanding the basic concepts, features, benefits of MetroPlusHealth MAP products.
• Responsible for selling the services provided by the Plan, such as covered benefits, non-covered benefits, exclusions and exemptions.
• Provide education on Medicaid Advantage Plus Plan features and benefits to consumers, providers, and business partners.
• Responsible for remaining informed of, and adhering to, marketing activity guidelines as set forth by various agencies such as HRA, DSS, SDOH.
• Responsible for assisting the consumer with the following:
  • Selecting a PCP
  • Completing required marketing materials and documentation as determined by MetroPlusHealth and various regulatory agencies such as HRA, DSS, SDOH.
  • Completion of enrollment form, required documents and reports i.e. transmittal reports, batch sheets top process an application for dual-eligible Medicare and Medicaid consumer eligible for MAP.
• Follow up on “Leads” and “Referrals” from family members, and caregivers of consumers eligible for enrollment in the MetroPlusHealth MAP product.
• Responsible for always maintaining an adequate supply of marketing materials.
• Conduct presentations to Home Care Agencies, support groups, caregiver trainings, etc. as well as conduct home visits, and personalized appointments as needed to complete the enrollment process.
• Routinely travel within Plan’s service area to conduct presentations to Home Care Agencies, support groups, caregiver trainings, etc. as well as conduct home visits, and personalized appointments as needed to complete the enrollment process.
• Routinely travel within Plan’s service are to ensure that promotional activities are conducted to promote the MetroPlusHealth MAP (i.e., placement of signage and brochures in patient waiting areas, conduct outreach calls, participate in events/health fairs and workshops attended by consumers, caregivers, and providers) including evening and weekend hours.
• Work closely with Outreach Representatives, Member Service Representatives, Eligibility Representatives, Utilization Management, and other MetroPlusHealth personnel to resolve member concerns regarding complaints and potential enrollment or disenrollment.
• Routinely travel within Plan’s service are to establish and sustain beneficial relationships with the Home Care Providers, Caregivers, medical specialist (Occupational/ Physical/Speech/Rehabilitation Therapist), Home Health Aides, Mental Health and Substance Abuse Providers, social workers, discharge planners and other providers that work with Medicaid Advantage Plus patients.
• Responsible for participation in weekly, bi-weekly, and monthly full staff, team and one-on-one meetings.
• Recognizing and implementing new marketing opportunities.
• Routinely travel within Plan’s service are to assisting members in accessing health care needs and other services as needed.
• Routinely travel within Plan’s service area to establish and maintain good working relationships with provider organizations and community organizations where marketing activities are conducted.
• Promoting the Vision, Mission, Values and Goals of MetroPlusHealth Plan.
• Routinely travel within service area to conduct and/or participate in telemarketing/outreach efforts as required.
• Responsible for the development and nurturing of long-term relationships with existing and new clients/providers to meet or exceed assigned sales targets for role.
• Serve as field base on-boarding collaborator for new sales staff, i.e., field shadowing, go to person for weekly/monthly referral report formatting and policy inquiries.
• Track key account metrics, preparing reports on account status, and analyzing client data to identify trends and opportunities.

Required Education, Training & Professional Experience 

• Must have a High School Diploma or GED, College Degree or coursework preferred
• 3-5 years of Sales and Customer Relations experience required.
• Medicaid Advantage Plus and Managed Long-Term Care Plan (MLTC) experience required.
• Valid NYS Driver’s License is a plus

Licensure and/or Certification Required 

• New York State Life, Accident and Health Insurance Agent License

#MPH50