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JOB SUMMARY

Provides subject matter expertise for member enrollment activities including identifying, interviewing and screening prospective eligible members for Molina health insurance products, assisting with health plan selection and enrollment processes, processing paperwork and ensuring documentation accuracy and follow-up. Develops and maintains relationships with local community agencies, health care organizations, and county/state agencies that refer potential eligible members and represents at community-based outreach events to aid enrollment efforts.

ESSENTIAL JOB DUTIES

• Meets monthly, quarterly, and annual member enrollment goals and growth targets
• Facilitates inbound/outbound calls to interview, screen and assist potential eligible members with enrollment processes into qualified Molina health plans
• Meets with potential members at various sites within applicable communities
• Provides education and support to potential members navigating the complex health care system by assisting with the application process, explaining requirements and providing necessary documentation
• Identifies and educates potential members on all aspects of applicable plans, including answering questions related to plan features and benefits and walking consumers through required disclosures
• Educates members on options to make premium payments, including due dates
• Assists members with plan and primary care physician selection
• Submits all completed applications, adhering to submission deadline dates as imposed by state specific requirements and Molina enrollment guidelines and requirements
• Identifies and assists current members who are due to recertify health care coverage by completing the annual recertification application, including add-on for additional eligible family members
• Responds to inquiries from prospective members according to marketing guidelines
• Adheres to health plan rules and regulations as applicable for member enrollment
• Participates in events and community outreach projects with other agencies as assigned by leadership for a minimum of eight hours per week
• Establishes and maintains good working relationships with external business partners such as hospital or provider organizations, city agencies and community-based organizations where enrollment activities are conducted
• Develops and strengthens relationships in order to generate new opportunities
• Attends community health fairs, events and external meetings as required
• Attends occasional weekend or evening events as needed
• Acts as a mentor or role model for other team members to share best practices for high performance and compliance

Local travel required

REQUIRED QUALIFICATIONS

• At least 5 years’ experience as a Medicaid Facilitated Enroller, CAC Navigator, Broker, or other relevant enrollment professional
• Knowledge of managed care insurance plans
• Demonstrated history of high performance or compliance
• Must have reliable transportation and a valid driver's license with no restrictions
• Ability to work with a diverse population, including different ethnicities, cultural backgrounds, and/or underserved communities
• Interpersonal/customer service skills
• Attention to detail, organizational and time-management skills, and ability to work independently and meet internal deadlines
• Ability to establish and maintain positive and effective work relationships with coworkers, members, providers, and customers
• Ability to maintain confidentiality and comply with the Health Insurance Portability and Accountability Act (HIPAA)
• Effective verbal and written communication skills, including strong presentation skills

Microsoft Office suite and applicable software programs proficiency

PREFERRED QUALIFICATIONS

Bilingual

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $24 - $56.17 / ANNUAL

• Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.