Medicare Outreach Agent (bilingual - Spanish)

Medicare Outreach Agent (Bilingual - Spanish)

Location : Gilroy, CA

Department : Medicare Outreach - 618

Employment Duration : Full-time

Salary Range : $85,740 - $128,610

FLSA Status : Exempt

Department : Marketing, Outreach and Enrollment

Reports To : Manager, Medicare Outreach

General Description Of Position

The Medicare Outreach Agent executes SCFHP's Medicare outreach and enrollment operations to grow SCFHP Medicare enrollment in compliance with all applicable state and federal regulatory requirements, SCFHP policies and procedures, and business requirements, and in support of organizational objectives.

Essential Duties And Responsibilities

To perform this job successfully, an individual must be able to satisfactorily perform each essential duty listed below.

• Execute sales and outreach strategy to maximize membership growth, including meeting Medicare enrollment goals as well as individual sales and performance goals.
• Ensure timely follow-up on questions, issues and concerns from beneficiaries, members, providers, community partners.
• Organize and conduct sales presentations in the community and assist eligible beneficiaries to enroll, including conducting a needs assessment to best explain product offerings.
• Make outbound calls to follow up and close business; receive and manage inbound enrollment calls.
• Manage and execute outreach plan to providers and community based organizations to support achievement of Medicare enrollment objectives.
• Seek opportunities to improve SCFHP image / visibility in the community. Contribute ideas to increase retention and enrollment.
• Develop, maintain and use competitive analysis to inform outreach and retention efforts, including identifying and studying key competitors and their products, as well as related industry issues to maintain a personal awareness of competitive advantages and disadvantages; share the competitive analysis with the Marketing and Outreach teams.
• Stay current on SCFHP product and competing products; stay current on CMS Medicare Marketing Guidelines and with California specific Medicare-Medicaid Plans Medicare Marketing Guidelines.
• Successfully complete SCFHP required product and certification training; maintain California Life, Accident and Health Insurance License.
• Identify issues and trends (data, systems, beneficiary, member, provider, other) as well as general departmental questions / concerns and report relevant information to management; make recommendations.
• Address member questions, concerns, grievances, appeals or requests for services in accordance with policies and procedures, including appropriate documentation and communication with other departments.
• Assist with new hire training by having new hires shadow, observe in the community, and listen to calls, in accordance with training guidelines and protocols. Observe new hires and provide feedback to the Department Manager.
• Attend and actively participate in daily, weekly, and monthly departmental meetings, training and coaching sessions.
• Perform other related duties as required or assigned.

Requirements Required (R) Desired (D)

The requirements listed below are representative of the knowledge, skill, and / or ability required or desired.

Working Conditions

Duties are performed away from the office in varied community settings, and also in an office environment while sitting or standing at a desk. Incumbent's responsibilities require frequent contact with beneficiaries, members and providers, as well as interaction with co-workers and managers, in person, by telephone, and via electronic communications.

Physical Requirements

Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation :

Environmental Conditions

Outside of the office community settings, meeting rooms. In the office general office conditions. May be exposed to moderate noise levels.

EOE