Medicare MAP Advisor

JOB SUMMARY

The Medicare MAP Advisor will promote and sell MAP and Medicare Line of Business, maintain relationships, service our existing customers, and secure new customers through consultative selling and marketing. The incumbent will educate and enroll potential beneficiaries by explaining program benefits in compliance with CMS and company policies and regulations.

MAP Advisor Primary Responsibilities

• Educate prospects on CPHL MAP product for full Medicaid and Medicare recipients needing in-home care and long-term care services.
• Manage day-to-day needs through Care Managers and provide care adjustments to help members stay home.
• No need for referrals.

Candidate Requirements

• Active NYS Health and Accident license
• AHIP certified
• Computer/technology literacy
• Compliant with CMS and CPHL policies
• Follow CPHL, CMS, and state guidelines relative to MAP including all enrollment procedures
• Develops and maintains relationships, leads, and new business
• Serves as a presence in the community and point of contact for current members
• Active listening and recommend plans and enroll prospects based on the customer’s needs
• Provide a positive customer experience with excellent customer satisfaction
• Ensures prospects are enrolled properly and all internal and external processes are followed
• Updates customer file in Case Tracker with summary of interaction
• Interacts with internal departments to ensure meeting deadlines for all documentation requirements
• Develops and nurtures relationship with prospective members, community leaders, owner hospitals, community partners, and current business partners
• Ensures individual enrollment quotas are met based on tenure
• Attends all Sales Meetings and gatherings
• Sets daily, mid-day, and end-of-day reports
• Maintains a professional image both on clothing attire and marketing locations

Position Responsibilities

• Encourages working weekends and requires frequent travel to various CPHL sites located throughout the five (5) boroughs
• Maintain CPHL MAP and Medicare Advantage Plan visibility in the community by monitoring multiple marketing locations and events
• Carries marketing table, materials, give-away items, and boxes
• Searches for additional marketing locations while adhering to company regulatory guidelines
• Continues education to stay abreast on all recent changes in regulations, recent training sessions, changes in workflow, and changes to company benefits
• Prepares for and scores favorably in all post and ongoing quizzes, refresher training, and administrative audits
• Prepared to be summoned by the Special Investigation Unit
• Adapts to various software used by CPHL, maintains an electronic book of business, researches participating providers, and communicates with internal departments via Microsoft Outlook
• Safeguards all equipment issued by Centers Plans for Healthy Living MAP and Advantage Care Medicare HMO Plan
• Ensures prospective members are enrolled properly and all internal and external processes are followed
• Ensures all documentation relative to the applications are attached (i.e. Application, Application Confirmation Form, Scope of Appointment and Application Submission Form)
• Enters all information into your book of business
• Ensures supporting documentation is provided to all new enrollees (i.e. Copy of Application, copy of Application Confirmation Form, Low Income Subsidy (LIS) Letter, before you go document, and a Summary of Benefit)
• Ensures any/all concerns are addressed and resolved within a reasonable time frame and/or directed to the appropriate party
• Ongoing communication outreach to membership; including but not limited to 30, 60, 90 day outreach to ensure member satisfaction
• Keeps management abreast on any recommendations that can make a workflow or process more efficient
• Keeps an open line of communication with the Site Development business unit
• This includes making management aware of any possible organizations that could transition into suitable business partners for Centers Plans for Healthy Living MAP and Advantage Care Medicare HMO Plan and/or any upcoming marketing events requiring participation
• Keeps management abreast on any activities CPHL MAP and Advantage Care Medicare HMO Plan competitors are engaging in
• This can range from a marketing approach, branding campaign, new designs or benefit changes
• Works in a concerted manner with Provider Relations / Network Development and communicates to them any providers that we should attempt to recruit
• Ensures Provider Relations/Network Development Representatives are abreast on any outstanding issues relative to any of our participating providers

EDUCATION AND EXPERIENCE

• Education: Minimum Qualifications: High School Diploma or GED
• Type of Experience: Must have at least 1 year of sales experience or relevant experience
• Knowledge of Corporate emails (such as Outlook, Excel), MS Word and Internet Explorer
• Specific Technical Skills: Great communication skills and collaboration skills

SCOPE INFORMATION

• # Direct Reports: Director of Medicare Marketing
• Physical Requirements: The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.