Enrollment Agent - PruittHealth Premier

Pruitthealth Corporation; Raleigh (NC); On-site; USD 42,000 - 62,000; Full time

Job summary

PruittHealth Corporation seeks an Enrollment Agent for PruittHealth Premier to explain plan benefits and answer questions from potential members or their representatives. This role identifies membership leads and assists with enrollment in ISNP/DSNP plans within participating nursing facilities.

You will coordinate with sales leadership, conduct facility and community marketing events, maintain CMS compliance, and travel to local facilities as needed to enroll residents and educate staff about

Qualifications

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

Responsibilities

• Explain plan benefits and answer questions for potential members.
• Enroll residents into ISNPs/DSNPs with sales leadership.
• Coordinate enrollment support with sales administration.
• Utilize sales techniques to drive enrollments while maintaining compliance.
• Follow CMS rules and enter referrals and enrollments into company systems.
• Travel to local nursing facilities and conduct marketing events.

Skills

Tech proficiency

Licensure

Web video comms

Written & verbal

Independent worker

MS Office

Travel willingness

CMS knowledge

Interpersonal skills

Tools

AHIP Certification

Job description

Job Description - Enrollment Agent - PruittHealth Premier (2611360)

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:

1. Serve as a licensed insurance agent to explain Plan benefits and answer potential member resident/responsible party questions.

2. Coordinate with sales leadership to effectively enroll residents into institutional special needs plans (ISNPs); and dual special needs plans (DSNPs)

3. Work effectively with sales administration management for as-needed enrollment admin support.

4. Successfully utilize sales closing skills to drive enrollments, maintaining a strong sale close rate.

5. Properly follow established sales policies and standard operating procedures, effectively utilizing and updating company systems and databases, including systems for entering referrals and enrollments.

6. Ability to learn and carry out Centers for Medicare & Medicaid Services rules and regulations.

7. 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.

8. Offer to participate in facility events for marketing of the plan in accordance with CMS guidelines.

9. Send monthly lists of upcoming enrollees to facility contacts, agency contacts prior to month end.

10. Ensure that all interactions with the member are compliant with CMS regulations

11. Conduct monthly facility audit in accordance with monthly checklist provided.

12. 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.

13. 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.
• 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

Qualifications

MINIMUM EDUCATION 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: (Preferred 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! Apply Now to get started at PruittHealth!

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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