Health Plan Enrollment Specialist

Molina Healthcare; New York (NY); On-site; USD 25,000 - 58,000; Full time

Job summary

Molina Healthcare in New York seeks a Member Enrollment Specialist to support enrollment activities, interview and screen prospective eligible members, and assist with plan selection and enrollment paperwork with precision.

You will build relationships with community agencies, attend outreach events, and travel locally to meet potential members. The role requires explaining plan features, deadlines, required disclosures, and helping members navigate the health system with courtesy and accuracy.

Qualifications

• Minimum 2 years in health care and/or customer/provider services, including at least 1 year with state/federal health insurance programs.
• Must hold Marketplace Certified (NYSOH CAC) or obtain certification within 30 days of hire.
• Reliable transportation and a valid driver's license with no restrictions.
• Strong interpersonal/customer service skills.
• Data processing and proofing experience.
• Attention to detail, organizational and time-management skills, and ability to work independently and meet deadlines.
• Positive attitude and adaptability.
• Knowledge of managed care insurance plans.
• Ability to work with diverse populations and maintain confidentiality (HIPAA).
• Ability to establish positive working relationships with coworkers, providers and customers.
• Strong verbal and written communication skills; proficient with Microsoft Office.

Responsibilities

• Meets monthly, quarterly, and annual member enrollment goals and growth targets.
• Facilitates inbound/outbound calls to interview, screen and assist potential eligible members with enrollment processes.
• Meets with potential members at various sites within applicable communities.
• Provides education and support to potential members navigating the enrollment process and documentation requirements.
• Explains plan features, benefits and disclosures; guides premium payment options and due dates.
• Assists members with plan and primary care physician selection.
• Submits completed applications within state deadlines and Molina guidelines.
• Identifies members due for recertification and assists with annual recertification.
• Responds to inquiries per marketing guidelines.
• Adheres to health plan rules and regulations for enrollment.
• Participates in events with other agencies for at least eight hours per week.
• Maintains relationships with external partners such as hospitals and providers.

Skills

Customer service

Attention to detail

Time management

Communication skills

Independent work

HIPAA knowledge

Tools

CAC Certification

Microsoft Office

Job description

Molina Healthcare in New York seeks a Member Enrollment Specialist to support enrollment activities, interview and screen prospective eligible members, and assist with plan selection and enrollment paperwork with precision.

You will build relationships with community agencies, attend outreach events, and travel locally to meet potential members. The role requires explaining plan features, deadlines, required disclosures, and helping members navigate the health system with courtesy and accuracy.