Specialist, Market Growth & Retention (Remote in NY)

Molina Healthcare; New York (NY); Remote; USD 23,000 - 53,000; Full time

Job summary

Molina Healthcare is seeking a dedicated Call Center/Member Support professional in New York to assist members with recertification, eligibility, and plan information. You will handle inbound calls, guide members through required documentation, and coordinate with care management to ensure satisfaction and retention.

The role emphasizes accurate data entry, cross-functional collaboration, and participation in community-based retention events, with CAC certification pursued within 60 days of hire

Qualifications

• : At least 2 years of customer service experience in call center/health care setting or equivalent education/experience.
• : Strong customer service acumen and ability to assess needs to support members.
• : Time-management and organizational skills.
• : Ability to work cross-functionally within a matrixed organization.
• : Effective verbal and written communication and professional phone etiquette.
• : Proficiency with Microsoft Office suite.
• : For New York state: CAC certification or ability to obtain within 60 days of hire.

Responsibilities

• Proactively facilitates outreach to Molina members regarding recertification with state/health plan; educates on processes, required documents, and completes applications to state.
• Assists and resolves complex member issues related to application errors, immigration status, multi-family enrollment, premiums, eligibility, etc.
• Manages individual state dashboards.
• Handles inbound member calls.
• Facilitates member reminders (product overviews, premiums, gaps in care, events).
• Closes at-risk care gaps, schedules appointments, directs to resources and care management opportunities to ensure member satisfaction and plan quality.
• Promotes and increases member enrollments into plan programs.
• Assists members in contacting care managers regarding eligibility issues and follows up as allowed.
• Outreach to retain late renewals, post terms, and potential disenrollments; explains required paperwork.
• Documents outreach accurately in databases.
• Collaborates with leadership to provide feedback and insights for improvement related to technology, processes, people, retention and member experience.
• Uses systems to input/output data related to member care and renewal status.
• Attends and assists with in-person community-based member retention events; supports renewals and eligibility processes as needed.
• Some in-office trainings, meetings and field work required based on state-specific/contractual needs.

Skills

Customer service

Time management

Organizational skills

Verbal and written communication

Microsoft Office

Job description

Provides support for member growth and retention activities including provision of telephonic application assistance for new and existing members seeking to obtain or maintain health care coverage, and confirms information accuracy for eligibility. Provides information to members (i.e. product overviews, premiums, gaps in care, care management, member engagement events, etc.) and assists as needed with resolution of issues, appointment scheduling, outreach to appropriate state entities, and provision of resources. Supports execution of member satisfaction, retention and quality initiatives.

Essential Job Duties

• Proactively facilitates outreach to Molina members regarding upcoming recertification with the state/health plan; educates members on processes, qualifications, required documentation, and completes applications and submissions to the state.
• Assists and resolves complex member issues related to application errors, immigration status, multi-family enrollment, premiums, eligibility, etc.
• Manages individual state dashboards.
• Handles inbound member calls.
• Facilitates member reminders (i.e. product overviews, premiums, gaps in care, member engagement events etc.).
• Facilitates the closure of at-risk care gaps, schedules appointments, conducts outreach to appropriate state entities, directs members toward available resources and care management opportunities to ensure member satisfaction, retention, and plan quality performance.
• Promotes and increases member enrollments into plan programs.
• Assists members in contacting respective care manager regarding eligibility issues and follow-up with members to ensure follow-through, if allowed by the member’s respective state.
• Conducts outreach to retain members that have been identified as late renewals, post terms and potential disenrollments, and assists and educates members on next steps and required paperwork.
• Accurately and timely documents outreach in appropriate databases.
• Collaborates with leadership team to provide feedback, trends and insights for areas of opportunity for improvement related to technology, processes, people, retention and the member experience.
• Accesses organizational based platforms and tools for the purpose of inputting and outputting data related to documenting member care, status, renewal status, etc.
• Attends and assists with in-person community-based member retention events.
• Assists with in-person renewals, eligibility issues, application updates, submission of paperwork etc.
• Some in office trainings, meetings and field work required based on business/state-specific/contractual needs.

Required Qualifications

• At least 2 years of customer service experience, preferably in a call center/health care environment, or equivalent combination of relevant education and experience.
• Strong customer service acumen.
• Ability to assess needs and make thoughtful decisions to support members.
• Time-management and organizational skills.
• Ability to work cross-functionally within a highly matrixed organization.
• Effective verbal and written communication skills, and professional telephone etiquette skills.
• Microsoft Office suite/applicable software program(s) proficiency.
• For the state of New York: Certified Application Counselor (CAC) and/or ability to obtain certification within 60 days of hire date.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $17 - $38.37 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.