Facilitated Enroller

Job Description

JOB DESCRIPTION

Job Summary

The Marketplace Facilitated Enroller (MFE) is responsible for identifying prospective members that do not have health insurance and assisting with the enrollment process ultimately making it easier for them to connect to the care they need. The MFE conducts interviews and screens potentially eligible recipients for enrollment into Government Programs such as Medicaid / Medicaid Managed Care, Child Health Plus and Essential Plan. Additionally, the MFE will assist in enrollment into Qualified Health Plans. The MFE must offer all plans and all products. MFEs assist families with their applications, provides assistance with completing the application, gathers the necessary documentation, and assists in selection of the appropriate health plan. The Enroller provides information on managed care programs and how to access care. The MFE is responsible for processing paperwork completely and accurately, including follow up visit documentation and other necessary reports. The MFE is also responsible for assisting current members with recertification with their plan. MFEs must source, develop and maintain professional, congenial relationships with local community agencies as well as county and state agency personnel who refer potentially eligible recipients.

KNOWLEDGE / SKILLS / ABILITIES

• Responsible for achieving monthly, quarterly, and annual enrollment goals and growth targets, as established by management.
• Interview, screen and assist potentially eligible recipients with the enrollment process into Medicaid / Medicaid Managed Care, Child Health Plus the Essential Plan and Qualified Health Plans for Molina and other plans who operate in our service area
• Meet with consumers at various sites throughout the communities
• Provide education and support to individuals who are navigating a complex system by assisting consumers with the application process, explaining requirements and necessary documentation
• Identify and educate potential members on all aspects of the plan including answering questions regarding plan's features and benefits and walking client through the required disclosures
• Educate members on their options to make premium payments, including due dates
• Assist clients with choosing a plan and primary care physician
• Submit all completed applications, adhering to submission deadline dates as imposed by NYSOH and Molina enrollment guidelines and requirements
• Responsible for identifying and assisting current members who are due to re-certify their healthcare coverage by completing the annual recertification application including adding on additional eligible family members
• Respond to inquiries from prospective members and members within the marketing guidelines
• Must adhere to all NYSOH rules and regulations as applicable for MFE functions
• Outreach Projects
• Participate in events and community outreach projects to other agencies as assigned by Management for a minimum of 8 hours per week
• Establish and maintain good working relationships with external business partners such as hospital and provider
• organizations, city agencies and community-based organizations where enrollment activities are conducted
• Develop and strengthen relations to generate new opportunities
• Attend external meetings as required
• Attend community health fairs and events as required
• Occasional weekend or evening availability for special events.

JOB QUALIFICATIONS

Required Education

HS Diploma

Required Experience

Required License, Certification, Association

Successful completion of the NYSOH required training, certification and recertification

Preferred Education

AA / AS - Associates degree

Preferred Experience

Previous experience as a Marketplace Facilitated Enroller

To all current Molina employees : If you are interested in applying for this position, please apply through the intranet job listing.

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