Marketplace Enrollment Specialist

EmblemHealth; New York (NY); On-site; USD 50,000 - 60,000; Full time

Job summary

EmblemHealth, a leading not-for-profit health insurer in New York, seeks a driven member outreach specialist to educate and enroll individuals in Medicaid, Essential Plan, QHP and CHP products. You will handle inbound/outbound calls, complete enrollment forms, and collaborate across departments to resolve member inquiries and improve service.

Travel within the New York metropolitan area is required; evening/weekend work may be necessary to support community outreach and enrollment campaigns.

Qualifications

• High School Diploma required.
• 2 years of relevant experience in member outreach or sales.
• Ability to travel in the NY metropolitan area.

Responsibilities

• Handle inbound calls from members and prospective enrollees.
• Educate members on plan benefits, enrollment, and renewal options.
• Present and sell Individual Medicaid, Essential Plan, QHP and CHP products.
• Complete enrollment forms and renewals for NYSOH or LDSS via phone or direct contact.
• Coordinate with internal teams to resolve member issues and improve service.

Skills

Interpersonal skills

Presentation skills

Organizational skills

Written communication

Self-generation of leads

Education

High School Diploma

Tools

Avaya

Facets

Salesforce

Sales Cloud

Service Cloud

ePACES

Job description

EmblemHealth is one of the nation’s largest not for profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, EmblemHealth partners with top hospitals and doctors, including its own AdvantageCare Physicians, to deliver quality, affordable, convenient care. At over a dozen EmblemHealth Neighborhood Care locations, members and non-members alike have access to community-based health and wellness guidance and resources. For more information, visit emblemhealth.com .

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• Responsible for making outbound calls to previous/current QHP, EP, Medicaid & Child Health Plus membership due to special projects, and renewal on a telephonic approach.

Principal Accountabilities

• Receive inbound calls directly from members/prospects or transfers from member services.
  
• Educate and respond to inquiries from members about plan benefits, enrollment, and renewal options.
  
• Present to, follow up and sell Individual Medicaid, Essential Plan, QHP and CHP products on a direct sales basis.
  
• Assist and enroll individuals by completing the appropriate application forms, obtain required documentation necessary for enrollment, and meeting necessary enrollment targets. Assist individuals by completing the appropriate forms and/or renewal applications for NYSOH or LDSS (via phone or direct basis).
  
• Function as a liaison between all EmblemHealth departments to help identify and capture prospect’s issue resolution or concerns.
  
• Work with Neighborhood Care and HUB (member services) teams to maintain and improve EmblemHealth’s image as a High Quality and Affordable health plan in the community.
  
• Maintain appointments, develop community marketing sites, establish relationships with community-based organizations, participate in healthrelated activities/special events including in person evening and weekend activities, create self-generated leads, and provide services to onsite walk-ins. Obtain feedback from referral sources and prospective enrollees.
  
• Assist QHP, EP, Medicaid & Child Health Plus members with billing inquiries, enrollment inquiries and PCP assignments.
  
• Utilize automated tools such as Avaya, Facets, Salesforce, Sales Cloud, Service Cloud & ePACES to perform daily duties and conduct telephonic outreach when necessary.
  
• Develop and maintain appropriate understanding of the health care products related to job functions.
  
• Regular attendance is an essential function of the job.
  
• Performs other duties as assigned or required.

Qualifications

Education, Training, Licenses, Certifications

• High School Diploma

Relevant Work Experience, Knowledge, Skills, and Abilities

• 2 years of relevant work experience required
  
• Driver’s License and automobile with appropriate coverage is required for territories – Long Island, etc. (Optional)
  
• Travel in the New York metropolitan area required
  
• Must be able to work nights and weekends as required
  
• Excellent interpersonal and presentation skills and the ability to work independently
  
• Excellent organizational and communication skills, both verbal and written
  
• Ability to develop strong relationships and influences in the community
  
• Ability to input and update data in database system
  
• Works independently and produces Self-Generated leads
  
• Ability to multi-task
  
• Successful completion of annual product training and testing to maintain certification

Additional Information

• Requisition ID: 1000003196
• Hiring Range: 50,000- 60,000

Security Disclosure

If you receive a job offer from EmblemHealth, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a Google Hangout, buy your own equipment, or pay to apply. We also do not use third-party email services like Yahoo or Gmail.

Pay Disclosure

At EmblemHealth, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at EmblemHealth, where your contributions are valued and supported by fair compensation.

EEOC Statement

We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, age, creed, citizenship status, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law.

Sponsorship Statement

At EmblemHealth, we are committed to building a diverse and talented workforce. However, we are unable to consider applicants who require, or are likely to require, either before or after hire, visa sponsorship for work authorization in the United States, including but not limited to H-1B, F-1 (STEM OPT), TN, or any other non-immigrant status. Some extremely rare exceptions may apply based on critical business needs.