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Healthfirst Linkedin · Posted 6d ago

Outreach Retention Specialist

Florida, United States

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Indexed description

The Outreach Retention Specialist is responsible for making outbound calls to existing PHSP, Medicare and Integrated Product membership. Includes educating and assisting current members over the phone with their renewal application and/or scheduling an appointment for a field staff to complete. There is no new enrollment activity for this position.

  • This position is 100% Remote

Duties And Responsibilities

  • Make outbound calls to existing membership up for renewal to assist over the phone and/or schedule appointments for a Field Representative to assist with a renewal application.
  • Educate members on all aspects of eligible plans including answering questions regarding features and benefits
  • Comply with HIPAA requirements and maintain Protected Health Information (PHI) confidentiality of member, provider, medical and departmental information; adhere to local, state, federal and Healthfirst specific compliance and regulatory guidelines
  • Certified application counselors to maintain personal NYSOH dashboard
  • Assist Medicaid, Medicare, and Integrated Product members through outbound campaigns to retain their and/or obtain coverage
  • Meet pre- and post-training exams and audit requirements
  • Attend annual training and successfully meet testing requirements
  • Understand and implement the Plan’s policies and procedures for the renewal process
  • Establish and maintain good working relationships with internal and external business partners such as Member Services, Enrollment, Medical Management, Marketplace Retention Specialist, Marketplace Facilitated Enrollers, Medicare Representatives, etc.
  • Work a flexible schedule including late shifts, weekends, and/or holidays (with limited notice at times), and as needed during unforeseen business disruptions
  • Work at locations which may include office, remote, virtual and/or field offices
  • Participate in weekly, bi-weekly, and monthly staff meetings and trainings including one-on-one meetings with management. Raise any issues / concerns to Management relative to retention opportunities, competition, training needs, and process improvement
  • Additional duties as assigned

Minimum Qualifications:

  • High School Diploma or GED from an accredited institution
  • Related work experience such as HMO / Managed Care, NYSOH, HRA, Maximus, etc.
  • Working experience with MS Office
  • Prior work experience with tools such as Salesforce/OnContact, MHS, ePaces, BizTalk

Preferred Qualifications:

  • Bachelor’s Degree
  • Exhibits the highest standards of personal ethics and integrity, taking accountability for actions and treating everyone with respect and fairness

Compliance & Regulatory Responsibilities: Noted above

License/Certification: CAC if enrolling on the NYSOH

Hiring Range*:

  • Greater New York City Area (NY, NJ, CT residents): $48,600 - $65,960
  • All Other Locations (within approved locations): $42,200 - $62,400

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

  • The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.
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