Enrollment Agent - PruittHealth Premier

PruittHealth; North Carolina; On-site; USD 52,000 - 78,000; Full time

Job summary

PruittHealth is seeking an Enrollment Agent for its Premier plan to serve as a licensed insurance agent who explains plan benefits and assists with enrollment for ISNP/DSNP residents.

The role includes outreach, marketing support to facility staff, and coordination with sales leadership. Must maintain licensure, AHIP certification, and a strong sales track record; travel within the assigned counties is required and CMS rules must be followed.

Qualifications

• Bachelor's degree required.
• Life & Health Insurance License required.
• AHIP Certification and licensed to sell Life and Health insurance in required states (preferred).
• Knowledge of Medicare/Medicaid and CMS regulations.

Responsibilities

• Explain Plan benefits as a licensed agent and answer questions.
• Enroll residents into ISNPs/DSNPs and support enrollment processes.
• Coordinate with sales leadership and administrative teams for enrollment.
• Maintain referrals and enrollments in company systems and databases.

Skills

Communication skills

Independent work

Sales experience

Interpersonal skills

Organizational skills

CMS regulations knowledge

Travel willingness

Computer skills

Presentations

Microsoft Office

Education

Bachelor's degree

Tools

Microsoft Office Suite

Video conferencing platforms

Job description

Job Purpose

The purpose of the Enrollment Agent role for PruittHealth Premier to serve as a licensed insurance agent to explain Plan benefits and answer the questions of potential members or their responsible party. Their role is to identify potential membership leads and help ensure timely outreach to assist with enrollment to the health plan. In addition, they provide ongoing marketing support to our in-network skilled nursing facility staff, conduct facility and community marketing events, and provider education both in our skilled nursing facilities and in our communities to support both our I-SNP and D-SNP as needed.

Key Responsibilities

• Serve as a licensed insurance agent to explain Plan benefits and answer potential member resident/responsible party questions.
• Coordinate with sales leadership to effectively enroll residents into institutional special needs plans (ISNPs); and dual special needs plans (DSNPs)
• Work effectively with sales administration management for as-needed enrollment admin support.
• Successfully utilize sales closing skills to drive enrollments, maintaining a strong sale close rate.
• Properly follow established sales policies and standard operating procedures, effectively utilizing and updating company systems and databases, including systems for entering referrals and enrollments.
• Ability to learn and carry out Centers for Medicare & Medicaid Services rules and regulations.
• Meet with potential members/responsible party to ensure that any questions are answered, existing benefits are compared to plan benefits and to act as a point of contact if the potential member or their family needs assistance during the enrollment process.
• Offer to participate in facility events for marketing of the plan in accordance with CMS guidelines.
• Send monthly lists of upcoming enrollees to facility contacts, agency contacts prior to month end.
• Ensure that all interactions with the member are compliant with CMS regulations
• Conduct monthly facility audit in accordance with monthly checklist provided.
• The Enrollment Agent will be responsible for a geographic territory of participating nursing facilities and counties for D-SNP marketing and enrollment within that same territory if applicable.
• Maintain current license to sell life and health insurance and AHIP certification to maintain employment in this role.

Knowledge, Skills, Abilities

• Strong technological skills to connect with potential members/families interested in enrolling
• Ability to maintain health insurance licensure and Continuing Education Requirements set forth by licensing state.
• Comfortable/patient in communicating via web-based video platforms.
• Assertive self-starter who is able to influence others.
• Strong written and verbal communication skills with abilities to deliver presentations in an impactful manner.
• Proven ability to work independently and productively.
• Strong computer skills and proficiency in Microsoft Office Suite products.
• Willingness to travel to local meeting places as needed.
• Substantial sales experience.
• Knowledge of Medicare/Medicaid and/or nursing community dynamics.
• Demonstrate compliance with CMS regulations regarding Medicare Advantage Plans and PruittHealth Code of Conduct.
• Demonstrate exceptional interpersonal skills with ability to work independently as well as with a team.
• Exceptional organizational skills: strong written and verbal communication and clear-thinking skills with the ability to synthesize complex issues into simple messages.
• Willingness and ability to travel to facilities within your assigned region; have dependable transportation, a current driver's license, a clean driving record, and proof of insurance.
• Have suitable home workspace allowing for productive office environment.
• Understands the PruittHealth Premier Plan benefits, PruittHealth Premier Plan policies, procedures and articulate them effectively to providers, potential members and key decisions makers.
• Complete annual Medicare Fraud, Waste and Abuse Training and Model of Care Training

Minimum Education Required

Bachelor's degree required

Minimum Experience Required

• 2 years health insurance sales experience preferred.
• Good communication skills and organizational skills needed
• Ability to professionally present plan benefits and financial information

Minimum Licensure/Certification Required by Law

Life & Health Insurance License

Additional Qualifications

• AHIP Certification and Licensed to sell Life and Health insurance in required states to act as an enrollment agent if necessary. (prefer they have this upon hire)

Family Makes Us Stronger.

Our family, your family, one family. Committed to loving, giving, and caring. United in making a difference.

We are eager to connect with you!

As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status.

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For more information regarding Florida's Care Provider Background Screening Clearinghouse Education and Awareness, please visit https://info.flclearinghouse.com

Job

Administrative

Primary Location

North Carolina-Raleigh

Other Locations

North Carolina-Charlotte

Schedule

Full-time

Shift

1st Shift

Job Posting

Sep 3, 2026, 4:01:33 PM

Work Locations

PruittHealth - Raleigh