Job Description

Empower. Unite. Care.

MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.

About NYC Health + Hospitals

MetroPlus Health provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus Health's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus Health has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.

The Medicare Sales Representative II provides greater access to health insurance, by providing education and assistance to Medicare individuals. The Medicare Sales Representative II is involved with health education through the distribution of health ed. materials and arranging for health screenings. In addition, the Medicare Sales Representative II provides Facilitated Enrollment, helps facilitate the continuance of health insurance, and offers assistance with recertification.

Job Description

Scope of Role & Responsibilities

• Identify prospective enrollees and determine eligibility for participation in MetroPlus Health’s Medicare product.
• Understand and apply all policies and procedure pertaining to:
  • Disclosures and provisions of the MetroPlus Health Medicare product.
  • Enrollment and disenrollment.
• Conduct home visits, and personalized appointments as needed to complete the enrollment process.
• Market MetroPlus Health Medicare line of business on-site at hospitals, senior centers, assisted living facilities, community events and other sites as designated.
• Understand the covered benefits, non-covered benefits, exclusions, and exemptions.
• Educating enrollees on all aspects of the Plan, as well as answering questions regarding Plan’s features and benefits.
• Keep informed and adhere to current information pertaining to marketing activity guidelines set forth by various regulatory agencies—this includes providing enrollees with all corresponding materials and documentation.
• Complete applications and field reports such as Presumptive Eligibility reports, and personnel forms (time sheets, expense reports, etc.) in a timely and accurate manner.
• Work closely with the Outreach Representatives, Customer Service Representatives Eligibility Representatives and other MetroPlus Health personnel to resolve member concerns regarding complaints and potential enrollments or disenrollments.
• Establish and maintain a positive working relationship with facility and site staff community and provider organizations, as well as City and State regulatory agencies.
• Assist members in accessing health care, transportation needs and other services or issues as they occur and pertain to members.
• Conduct and participate in telemarketing/outreach efforts as required.
• Provide detailed reports of production and outreach activities.
• Develop a presence in the local community to help generate enrollments.
• Making presentations to large groups of seniors.
• Required to complete Annual Medicare Training

Minimum Qualifications

Required Education, Training & Professional Experience

• Must have a High School Diploma or GED, College Degree or coursework preferred
• 3-5 years of Sales/Customer Relations experience required
• Medicare Sales experience preferred
• Public speaking experience
• Excellent organizational, written and communication skills
• Excellent verbal, and presentation skills are necessary
• Excellent problem-solving skills
• Highly motivated and goal directed
• Must be able to work in a multi-ethnic, multi-cultural environment
• Must be sensitive to chronic conditions and disabilities
• Bi-Lingual and Multi-Lingual a plus
• Must be self-confident, independent thinker and maintain a professional presentation of self
• Must demonstrate flexibility and willingness to learn
• Ability to coordinate and execute Sales events
• Assist with departmental projects when needed
• Computer skills required (Excel, PowerPoint, Word, Microsoft teams)

Licensure and/or Certification Required

• Must possess a valid NYS Life, Accident and Health Agent License at the time of employment. License must remain valid at all times during employment with no lapse in coverage. Must maintain all required continuing education requirements and renew license in advance of its expiration.
• Valid NYS Driver’s License is a plus

Professional Competencies

• Integrity and Trust
• Customer Focus
• Functional/Technical skills
• Written/Oral Communication

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