Bilingual Senior Retention Advocate

Job ID and requisition details available upon request.

About the role

The Bilingual (Spanish and/or Mandarin/Cantonese) Senior Retention Advocate (SRA) educates and supports Healthfirst members in obtaining financial entitlements to maintain independence at home and in their communities. This role manages cases from start to finish, providing education on cost-saving programs, assisting with applications, and offering follow-up support. The SRA works in a fast-paced, paperless environment, handling multiple tasks independently and communicating complex information to members via phone, in-person, or electronic documentation tools.

Responsibilities

• Educate and assist Healthfirst members in obtaining financial entitlements for which they are eligible.
• Serve as an advocate between members, support networks, and service providers to maximize participant support.
• Research eligibility, exclusion, and exemption codes using designated tools and platforms.
• Consult with Human Resource Administration (HRA)/Local Department of Social Services (LDSS) Medicaid staff as needed.
• Track Medicaid/Medicare/Medicare Savings Program (MSP) status for members until entitlements are resolved.
• Assist members with completing applications in a timely and organized manner, including collecting required documents.
• Submit documentation to HRA/LDSS within specified timeframes to ensure Medicaid coverage.
• Monitor applications according to HRA/LDSS/Social Security/Medicare timelines.
• Document all client calls and outcomes in database systems and spreadsheets.
• Track work, maintain accurate data, and prepare/submit monthly reports to management.
• Maintain awareness of changes in Medicaid/Medicare/HMO laws and share information with team members.
• Participate in entitlement training and meetings as directed.
• Contribute creative solutions and take ownership of daily assignments to ensure effective communication and project completion.
• Assist with the orientation of new hires and answer routine program questions.
• Handle additional duties as assigned, including occasional weekend work, extended hours, or travel to other Healthfirst sites.

Requirements

• High School diploma or GED from an accredited institution.
• Ability to travel throughout the five boroughs, Westchester, Orange, Sullivan, Rockland, and Nassau County.
• Well-organized, detail-oriented, and adaptable to procedural changes.
• Strong data entry skills and ability to maintain monthly spreadsheets for tracking and statistical purposes.
• Experience managing member information or appointments in a shared network environment using paperless database modules.
• Proficiency with electronic Patient Health Information (PHI) databases and security tools, including TrucareHTML5, RightFax, VoIP, Virtual Work Platforms (VPN), Adobe Acrobat, MS Office 365 (Word, Excel, Outlook), Interaction Client, and Jabber.
• Utmost integrity and discretion when handling patient records, personal/financial profiles, and documents.

Preferred Qualifications

• Associate degree from an accredited institution.
• Prior experience with Medicaid, Medicare, or Medicare Savings Programs.
• Experience working with adult or elderly populations.
• Customer service experience, preferably in an inbound and outbound call center within a healthcare environment.
• Understanding of integrated care.
• Experience in health insurance, home care, acute, sub-acute, long-term care (LTC), or managed-long term care (MLTC).
• At least five years in a health plan sales role with a proven record of producing maximum results in a compliant manner.

Pay

Greater New York City Area (NY, NJ, CT residents): $58,900 - $80,070

All Other Locations (within approved locations): $51,000 - $74,880

Salary and compensation are contingent upon work experience, education, licenses, certifications, and other factors deemed pertinent by Healthfirst.

Benefits

• Medical, dental, and vision coverage.
• Incentive and recognition programs.
• Life insurance.
• 401k contributions.

All benefits are subject to eligibility requirements.