MAP Sales Representative II - NYS Life, Accident and Health License Required

Educate and Enroll

Educate and enroll dual-eligible Medicaid and Medicare consumers for the MetroPlusHealth Medicaid Advantage Plus (MAP) product.

Identify dual-eligible Medicaid and Medicare consumers via Home Care Agencies, Adult Day Care Centers, DME Provider offices, Caregiver Resources Centers, specialty provider offices, HHC Long-Term Care Facilities, etc.

Understand and apply all policies and procedures pertaining to:

• Disclosures and provisions of the various MetroPlusHealth Plan products.
• Enrollment and disenrollment for the MAP line of business.

Selling Services

Complete enrollment calls and workflows resulting in smooth initial and plan-to-plan transfers.

Responsible for understanding the basic concepts, features, benefits of MetroPlusHealth MAP products.

Responsible for selling the services provided by the Plan, such as covered benefits, non-covered benefits, exclusions and exemptions.

Consumer Education

Provide education on Medicaid Advantage Plus Plan features and benefits to consumers, providers, and business partners.

Marketing and Outreach

Responsible for remaining informed of, and adhering to, marketing activity guidelines as set forth by various agencies such as HRA, DSS, SDOH.

Assist the consumer with the following:

• Selecting a PCP
• Completing required marketing materials and documentation as determined by MetroPlusHealth and various regulatory agencies such as HRA, DSS, SDOH.
• Completion of enrollment form, required documents and reports i.e. transmittal reports, batch sheets top process an application for dual-eligible Medicare and Medicaid consumer eligible for MAP.

Travel and Meetings

Routinely travel within Plan’s service area to conduct presentations to Home Care Agencies, support groups, caregiver trainings, etc. as well as conduct home visits, and personalized appointments as needed to complete the enrollment process.

Routinely travel within Plan’s service area to ensure that promotional activities are conducted to promote the MetroPlusHealth MAP (i.e., placement of signage and brochures in patient waiting areas, conduct outreach calls, participate in events/health fairs and workshops attended by consumers, caregivers, and providers) including evening and weekend hours.

Work closely with Outreach Representatives, Member Service Representatives, Eligibility Representatives, Utilization Management, and other MetroPlusHealth personnel to resolve member concerns regarding complaints and potential enrollment or disenrollment.

Provider Relationships

Work closely with Outreach Representatives, Member Service Representatives, Eligibility Representatives, Utilization Management, and other MetroPlusHealth personnel to resolve member concerns regarding complaints and potential enrollment or disenrollment.

Responsible for working with the following providers:

• Home Care Providers
• Caregivers
• Medical specialists (Occupational/ Physical/Speech/Rehabilitation Therapist)
• Home Health Aides
• Mental Health and Substance Abuse Providers
• Social workers
• Discharge planners
• Other providers that work with Medicaid Advantage Plus patients.

Team Meetings and Reporting

Participate in weekly, bi-weekly, and monthly full staff, team and one-on-one meetings.

Recognize and implement new marketing opportunities.

Track key account metrics, preparing reports on account status, and analyzing client data to identify trends and opportunities.

Client Relationships

Responsible for the development and nurturing of long-term relationships with existing and new clients/providers to meet or exceed assigned sales targets for role.

Field Onboarding

Serve as field base on-boarding collaborator for new sales staff, i.e., field shadowing, go to person for weekly/monthly referral report formatting and policy inquiries.

Policy Inquiries

Track key account metrics, preparing reports on account status, and analyzing client data to identify trends and opportunities.