Medicare Insurance Sales Consultant II
2 weeks ago
Empower. Unite. Care. MetroPlusHealth is dedicated to empowering New Yorkers by fostering community connections through quality care. We hold the belief that healthcare is a fundamental right. If you possess compassion and a collaborative mindset, consider joining our team. Take pride in your work every day.
About NYC Health + Hospitals
MetroPlus Health delivers top-tier healthcare services to residents across Bronx, Brooklyn, Manhattan, Queens, and Staten Island through a wide array of offerings, including New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, and more.
As a fully-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus Health's network encompasses over 27,000 primary care providers, specialists, and participating clinics.
For over three decades, MetroPlus Health has been devoted to nurturing strong relationships with its members and providers, enabling New Yorkers to lead their healthiest lives.
Position Overview
The Medicare Sales Consultant II is responsible for educating and assisting eligible individuals in acquiring affordable health insurance coverage and determining eligibility for Qualified Health Plans (QHPs) and insurance affordability programs such as Medicaid and Child Health Plus (CHP) through the NY State of Health Marketplace.
This role involves identifying and educating prospective members who lack health insurance or are seeking to change their coverage, as well as aiding existing members with recertification and benefit education.
The Sales Consultant II is expected to perform all duties in compliance with the Affordable Care Act (ACA) and other relevant regulations.
Educational/Enrollment Process
- Provide education and assistance to qualified individuals applying for coverage through the NY State of Health Marketplace in a Qualified Health Plan (QHP) and insurance affordability programs.
- Assist consumers with contacting the NY State of Health Customer Services Department for enrollment help and verification documentation.
- Conduct public education initiatives to raise awareness of available QHPs within the Marketplace.
- Explain potential eligibility for public/governmental programs, the workings of federal health insurance premium tax credits, and cost-sharing reductions.
- Detail the features and benefits of health insurance coverage, including cost-sharing mechanisms like deductibles, co-pays, and co-insurance.
- Clarify the different metal tiers within the Marketplace and how benefits may vary based on consumer income.
- Conduct presentations and participate in ACA forums and workshops as requested.
- Assist consumers with document submissions required by the Marketplace.
- Support existing members with recertification as needed.
- Help consumers with premium payment submissions when necessary.
Regulatory/Compliance
- Safeguard confidential information to prevent unauthorized access to Protected Health Information (PHI) and ensure compliance with privacy standards.
- Provide information in a culturally and linguistically appropriate manner for the population served by the Marketplace.
- Participate in all necessary training, updates, and webinars to fulfill role responsibilities.
- Meet annual Marketplace Facilitated Enroller (MFE) recertification requirements.
- Stay informed about industry and regulatory updates related to the ACA and Marketplace.
- Maintain confidentiality regarding business-related files and conversations as per applicable regulations.
Tactical Responsibilities
- Maintain a daily tracking tool detailing representative activities.
- Monitor applications in the personal dashboard for timely follow-through.
- Conduct daily reviews of the dashboard to address potential leads for consumer assistance.
- Ensure a consistent supply of educational and product collateral.
- Stay updated on Marketplace functionalities to effectively manage individual accounts.
- Record all follow-up dispositions promptly and accurately.
- Enter applicant demographic and enrollment data in the required systems during initial encounters.
- Fulfill all other tasks and responsibilities as needed to meet role expectations.
Minimum Qualifications
- High School Diploma or GED required.
- Minimum of three (3) years of Sales/Customer Relations experience.
- Experience in Public Speaking.
- Compliance with all conflict-of-interest standards and regulations.
- Availability to work evenings and weekends.
Licensure and/or Certification Required
- Completion and passing of the NY State of Health approved training program and certification.
- Completion of all required annual recertification as an MFE.
Professional Competencies
- Integrity and Trust
- Customer Focus
- Functional/Technical Skills
- Written/Oral Communication
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