Team Lead, Entitlement Advocate

3 weeks ago

Monsey, United States Health First Full time

Supervise Enrollment Medicaid Specialists. This includes observing staff in the field and conducting customer phone surveys to ensure all enrollment and Medicaid applications are completed in accordance with Company protocols and State regulations.

Travel within NYC, Westchester, and Nassau counties.

Track the Enrollment/Medicaid Application outcomes, to meet department enrollment conversion goals. Address patterns of appointments outcomes: Not interested, re-scheduled or cancelled prospects/members.

Track/ensure timely, accurate completion & submission of enrollment Medicaid application outcomes.

Coordinate a synchronized workflow while maintaining the integrity of confidential information about prospective enrollees, as well as proprietary business information in collaboration with staff in Marketing, Relationship Coordinators, Intake RN, Intake Coordinators, Welcome Team Supervisors, and Referral Sources.

Conduct monthly audits established by yearly audit plan in the areas of Enrollment, Medicaid, and Customer Service surveys, tracking of Enrollment and Medicaid applications/documents.

Handle other duties as assigned with the occasional need to work weekends, on-call, additional hours before or after shift schedule and/or from other HF site locations.

Directs the Enrollment-Entitlement process by explaining features to callers, entering activities into proprietary Employee Medical Records system, responding to questions from enrollees/significant others and resolving daily routine problems including complicated cases.

Monitors Medicaid re-certification time frames for each active member and assists with completion of re-certification application.

Prepares monthly summary reports for Director/VP Operations to show status of re-certifications, Medicaid issues and applications.

Serves as a resource on Medicaid and other entitlement programs for Care Team.

Keeps up to date on Medicaid and other entitlement program issues and on changes in Medicaid/Medicare/HMO laws and shares information with Care Team Social Work and other Care Team members as appropriate.

Contribute to continuous performance improvements, this includes but not limited to monitoring staff effectiveness based on productivity, conversion of referral to enrollment, documentation, accuracy of data entry, and overall timeliness of the intake and assessment process.

Minimum Qualifications:

High school diploma or GED equivalent

Maintain a calm and even disposition even during the handling of crisis situations.

Ability to multitask and remain focused in an environment with distractions.

Follow protocols and use common sense to escalate situations to management and clinical staff appropriately.

Ability to be persuasive and establish credibility and trust along with positive and affable working relationships with direct reports, internal and external clients, etc.

Excellent communication skills, especially in one-on-one and small-large group settings and while interacting with prospective clients or customers to explain products/services are essential.

Experience exercising independent thinking, problem solving and achieving quotas/goals.

Must be able to discern diversified cultural differences and needs of assigned communities such as Spanish, Chinese, Russian, Creole, and Korean.

Aptitude for using a fast-paced proactive vs. reactive approach, maneuvering multiple tasks simultaneously including seamlessly changing priorities.

  • Team Lead, Entitlement Advocate

    1 month ago

    Monsey, United States Health First Full time

    Supervise Enrollment Medicaid Specialists. This includes observing staff in the field and conducting customer phone surveys to ensure all enrollment and Medicaid applications are completed in accordance with Company protocols and State regulations. Travel within NYC, Westchester, and Nassau counties. Track the Enrollment/Medicaid Application outcomes, to...

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