Specialist, Market Growth & Retention (Remote in NYC, Tue - Sat Schedule)

Molina Healthcare is seeking a Specialist, Market Growth & Retention to support member growth, retention, and healthcare coverage activities. The role provides telephonic and in-person application assistance, resolves eligibility and enrollment issues, conducts member outreach, supports care-gap closure and appointment scheduling, and documents activities accurately.

Responsibilities:

• 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

Requirements:

• 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