Job description

JOB DESCRIPTION

Job Summary

The Marketplace Facilitated Enroller (MFE) is responsible for identifying prospective members that do not have health insurance and assisting with the enrollment process ultimately making it easier for them to connect to the care they need. The MFE conducts interviews and screens potentially eligible recipients for enrollment into Government Programs such as Medicaid/Medicaid Managed Care, Child Health Plus and Essential Plan. Additionally, the MFE will assist in enrollment into Qualified Health Plans. The MFE must offer all plans and all products. MFEs assist families with their applications, provides assistance with completing the application, gathers the necessary documentation, and assists in selection of the appropriate health plan. The Enroller provides information on managed care programs and how to access care. The MFE is responsible for processing paperwork completely and accurately, including follow up visit documentation and other necessary reports. The MFE is also responsible for assisting current members with recertification with their plan. MFEs must source, develop and maintain professional, congenial relationships with local community agencies as well as county and state agency personnel who refer potentially eligible recipients.

KNOWLEDGE/SKILLS/ABILITIES

Responsible for achieving monthly, quarterly, and annual enrollment goals and growth targets, as established by management.

Interview, screen and assist potentially eligible recipients with the enrollment process into Medicaid/Medicaid Managed Care, Child Health Plus the Essential Plan and Qualified Health Plans for Molina and other plans who operate in our service area

Meet with consumers at various sites throughout the communities

Provide education and support to individuals who are navigating a complex system by assisting consumers with the application process, explaining requirements and necessary documentation

Identify and educate potential members on all aspects of the plan including answering questions regarding plan's features and benefits and walking client through the required disclosures

Educate members on their options to make premium payments, including due dates

Assist clients with choosing a plan and primary care physician

Submit all completed applications, adhering to submission deadline dates as imposed by NYSOH and Molina enrollment guidelines and requirements

Responsible for identifying and assisting current members who are due to re-certify their healthcare coverage by completing the annual recertification application including adding on additional eligible family members

Respond to inquiries from prospective members and members within the marketing guidelines

Must adhere to all NYSOH rules and regulations as applicable for MFE functions

Outreach Projects

Participate in events and community outreach projects to other agencies as assigned by Management for a minimum of 8 hours per week

Establish and maintain good working relationships with external business partners such as hospital and provider

organizations, city agencies and community-based organizations where enrollment activities are conducted

Develop and strengthen relations to generate new opportunities

Attend external meetings as required

Attend community health fairs and events as required

Occasional weekend or evening availability for special events.

JOB QUALIFICATIONS

Required Education

HS Diploma

Required Experience

Minimum one year of experience working with State and Federal Health Insurance programs and populations

Demonstrated organizational skills, time management skills and ability to work independently

Ability to meet deadlines

Excellent written and oral communication skills; strong presentation skills

Basic computer skills including Microsoft Word and Excel

Strong interpersonal skills

A positive attitude with ability to adapt to change

Must have reliable transportation and a valid NYS drivers' license with no restrictions

Knowledge of Managed Care insurance plans

Ability to work with a diverse population, including different ethnicities, cultural backgrounds, and/or underserved communities

Ability to work a flexible schedule, including nights and weekends

Required License, Certification, Association

Successful completion of the NYSOH required training, certification and recertification

Preferred Education

AA/AS – Associates degree

Preferred Experience

Previous experience as a Marketplace Facilitated Enroller • Bilingual – Spanish & English

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

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

Pay Range: $14.90 - $29.06 an hour*

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

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