Specialist, Market Growth & Retention (Remote in NY) - Bilingual – Spanish

Molina Healthcare is seeking a Specialist in Market Growth & Retention to assist members with state-required applications for healthcare coverage. The role involves proactive outreach to members, resolving complex issues, and ensuring member satisfaction and retention through various initiatives.

Responsibilities:

• Pro-actively facilitate outreach (and handle inbound calls) to Molina members regarding their upcoming recertification with the state and healthplan. Educating members on process, qualifications, necessary documentation needed etc; while completeing the required applications and submissions to the State
• Management of individual State dashboards required
• Assist and resolve complex member issues related to application errors, immigration status, multi-family enrollment, premiums, eligibility; etc
• Provide non-clinical reminders (i.e. product overviews, premiums, gaps in care, member engagement events etc.)
• Facilitate the closure of at-risk care gaps, scheduling appointments, conducting outreach to appropriate State entities, direct toward available resources and care management opportunities; to ensure member satisfaction, retention, and drive plan quality performance
• Responsible for promoting and increasing member enrollments into plan programs (i.e.; Member portal, Rewards Program, etc.)
• Assists Medicaid Members in contacting their social worker regarding eligibility issues and follow-up with members to ensure follow through, if allowed by the member’s respective state
• Conduct outreach to retain members that have been identified as late renewals, post terms and potential disenrollments, assist and educate members on next steps and required paperwork
• Accurately and timely documentation of outreach in the appropriate databases
• Collaborate with the leadership team to provide feedback, trends and insights for areas of opportunity for improvement related to technology, process, people, retention and member experience
• Access a number of organizational based platforms and tools for the purpose of inputting and outputting data, related to documenting member care, status, renewal status etc. (such as: Salesforce, CCA, Sharepoint, Excel, Genesys etc)
• Attend and assist with in-person community based member retention events
• Placement in demonstrated high foot traffic locations, to assist with member in-person interactions may be required. Assist with in-person renewals, eligibility issues, application updates, submission of paperwork etc
• Maintain appropriate certifications and quality scores in compliance with the State and Molina Healthcare
• Some in office trainings, meetings and field work required; will be based on business needs
• Other tasks or special projects as required or directed

Requirements:

• High School Diploma or equivalent
• 2-4 years customer service experience, preferably in a call center environment
• Experience communicating with members in a customer service setting and have the ability to assess needs and make thoughtful decisions to help a member
• Must have NYS Certified Application Counselor Certification and/or be able to obtain certification within 60 days of hire date
• Associate's Degree or equivalent combination of education and experience
• 3-5 years customer service experience in a call center environment