Medi-Medi Specialist

Date: Jan 8, 2022

Location: Rancho Cucamonga, CA, US

Company: Inland Empire Health Plans

Job Requisition ID: 5550 

 

Position Summary/Position

 

Under the direction of the Medicare Sales Manager, the Medi-Medi Specialist - Bilingual is primarily responsible to ensure current IEHP DualChoice Cal MediConnect members continue Medi-Cal eligibility so that the member is not disenrolled from the IEHP DualChoice Cal MediConnect program. The goal is to reduce the number of dis-enrollments occurring monthly in our IEHP DualChoice Cal MediConnect program caused by members falling out of Medi-Cal.

 

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. Responsible for ensuring IEHP DualChoice Cal MediConnect members do not lose IEHP Medi-Cal eligibility due to the Medi-Cal deeming period; prevent disenrollment from the IEHP DualChoice Cal MediConnect program.
2. Retention of our existing IEHP DualChoice Cal MediConnect members by connecting them to their Medi-Cal office so they are not disenrolled or lose Medi-Cal eligibility, which would remove individual from the IEHP DualChoice Cal MediConnect Program.
3. Assist in the development of overall Medi-Medi Program that will serve to lower our IEHP DualChoice Cal MediConnect disenrollment rate due to the Medi-Cal deeming period.
4. Develop a complete understanding of the Medi-Cal eligibility process and resources by the state and within IEHP.
5. Develop a complete understanding of Medicare Sales processes, resources, training programs and quality assurance programs as well as the interaction process and understanding of CMS regulations, and PnP’s for Medicare Sales department.
6. Collaborate with Medicare Sales Manager to ensure feedback and communication of relevant information based on call activities and findings. Act as a resource in helping identify research and improve the deeming processes and procedures affecting the quality of service provided to IEHP DualChoice members.

Supervisory Responsibilities

Leading: Self

Experience Qualifications

 

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

 

Two or more years of relevant experience. Professional phone etiquette with experience in a call center atmosphere.

Preferred Experience

 

Experience preferred in Medicare and Medi-Cal at a managed care health plan or health care setting.

Education Qualifications

 

High School diploma or GED required.

Preferred Education

 

Bachelors degree in Healthcare, Communications or related field from an accredited institution preferred.

Drivers License Required

No

Knowledge Requirement

 

Knowledge of Medicare managed care and Medi-Cal managed care preferred. Understanding of and sensitivity to a multi-cultural environment and community.

Skills Requirement

 

Efficient in an office environment, including strong computer skills in Microsoft Word and Excel. Excellent interpersonal, communication, and coordination skills.

Abilities Requirement

 

Ability to coordinate and take lead for specific projects requiring accurate tracking, extensive follow-up and adhering to strict timelines. Must have a high degree of patience and attention to detail. Efficient in an office environment.

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 involving computer keyboard and screens, filing and copying of records and/or correspondence.

 

Starting Salary: $40,601.60  - $50,752.00  

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