Enrollment Advisor

Date: Jan 8, 2022

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 6450 

 

Position Summary/Position

 

Under the direction of the Enrollment Assistance Manager, the Enrollment Advisor is responsible for providing full-service application assistance to the uninsured, including: screen for program eligibility, complete a Covered California or Medi-Cal application, and submit the application to Covered California or Medi-Cal Office on behalf the applicant. The Advisor will follow up on the submission to ensure the application is processed and a final decision is made on applicant's eligibility. For active Medi-Cal beneficiaries who want to enroll with IEHP, the Advisor will complete a Health Plan Choice Form to be submitted to State for approval. Additional responsibilities include outbound calls to help current Members retain their Medi-Cal eligibility through annual redetermination process. The Advisor will also be out on the field upon requested for external enrollment events.

 

This is a Bilingual (English/Spanish) position. The team member in this role must take a language proficiency assessment and receive a minimum score of 9.

Major Functions (Duties and Responsibilities)

 

1. Pass and maintain any necessary license or certification required for any Health Program IEHP is participating in.
2. Consistently meet or exceed daily, weekly and monthly quotas for providing screening and/or application assistance, for inbound and outbound calls. Failure to meet established quotas on a consistent basis will be grounds for immediate performance review.
3. Will work a normal (8 a.m. – 5 p.m. or 9 a.m. – 6 p.m.) workday, but work schedules and hours may vary depending upon Marketing and Advertising meetings, promotions and trainings. The Enrollment Advisor will be provided at least one week’s notice when a managerial change of a work schedule and/or hours is required.
4. Provide telephone screening and/or application assistance for Medi-Cal,, Healthy Kids and other state health programs. As appropriate, the EA  will fill out any applicable application form, while the customer is on the phone, then provide instruction for all related follow-up procedures and processes.
5. Provide in person assistance and/or application completion to any potential member who walks in and requests enrollment assistance, application completion and/or information.
6. Qualify candidates by calculating their household income and by using other approved qualification methods and worksheets.
7. Become an expert regarding State Health Programs and the application and enrollment process, to advise candidates of the documentation required to complete the application and answer questions and issues about the enrollment process.
8. Completion of all assigned reports or documentation to facilitate the successful enrollment into a designated program to include: qualification worksheets, applications, appropriate letters, instructions to potential candidates and daily/weekly activity reports.
9. Must be courteous, friendly and customer oriented.
10. Must have the ability to multi-task in a high pressure environment while maintaining a high level of performance.
11. Must be comfortable working with a language line, translators and other special devices and programs when communicating with candidates that speak other languages and/or have a disability.
12. Must be an independent self-starter who effectively communicates parameters of a Health Program within the guidelines of a defined script.
13. At times will be asked to assist in the development and training of new Enrollment Advisors.
14. Will be responsible for incoming and outgoing mail and other administrative unit duties.
15. Documents all calls in detail so a recorded history is created for future interaction with each family.
16. Ability to present cases and work with a Supervisor in resolving potential member or member issues.
17. Ability to answer questions from potential members, and act as a subject matter expert in regards to state programs (Medi-Cal/Healthy Families).

Supervisory Responsibilities

Leading: Self

Experience Qualifications

 

Bilingual (English/Spanish) - written and verbal skills required

One to three years of experience in the following disciplines is highly desirable:
In-house sales
High-volume telemarketing
High-volume consumer products/industrial distribution order taking
Customer Service in a high-call-volume environment

Education Qualifications

 

High school diploma or GED required.

Professional Certification

 

Certification/License from Covered California (California's Health Exchange) to conduct Covered California and Medi-Cal Application is required. If not possessing a Certification at the time of hire, the candidate is required to obtain this Certification within 6 months after been hired. This Certification needs to be renewed annually through an annual certification process conducted by Covered California.

Drivers License Required

Yes, must have a valid California Driver's License.

Knowledge Requirement

 

Knowledge of the Healthy Kids Program, Medi-Cal or Managed Care Health Care Benefits desired, but not required. Understanding and sensitivity to a multi-cultural environment.

Skills Requirement

 

Excellent PC skills with emphasis on data entry, spreadsheet, word-processing.  Must have excellent verbal communication skills. Positive and professional interpersonal skills.

Abilities Requirement

 

Superior time management and organization habits. 

Commitment to Team Culture

 

The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.

Working Conditions

 

Word processing and data entry involving computer keyboard and screens.

 

Starting Salary: $38,563.20  - $45,302.40  

Pay rate will commensurate with experience

 

Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region. With a provider network of more than 6,000 and a team of more than 2,000 employees, IEHP provides quality, accessible healthcare services to more than 1.2 million members. And our mission and core values help guide us in the development of innovative programs and the creation of an award winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and Make a Difference with us! IEHP offers a Competitive salary and a benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and retirement plan.

 


Nearest Major Market: Riverside
Nearest Secondary Market: Los Angeles