Job Information
Healthfirst Team Lead, Entitlement Advocate in New York, New York
The Team Lead, Entitlement Advocate oversees the activities of Entitlement Advocates who provide Healthfirst's Medicare Advantage Plan (MAP) and Senior HealthPartners' (SHP) Managed Long-term Care (MLTCP) members and families with assessment and interventions related to enrollment processing of qualified, eligible candidates for enrollment and obtaining and retaining of financial entitlements for which they are eligible. Ours is a paperless work environment requiring daily hands-on administration of multiple proprietary and packaged electronic databases including security requirement tools such as encryption. These systems include, but are not limited to, Electronic Medical Records (EMR), Sunguard Macess Service Module for electronic archiving, eFax, VoIP, Virtual Work Platforms (using VPN), and scanning.
Supervise Enrollment Medicaid Specialists. This includes observing staff in the field and conducting customer phone surveys to ensure all enrollment and Medicaid applications are completed in accordance with Company protocols and State regulations.
Travel within NYC, Westchester, and Nassau counties.
Track the Enrollment/Medicaid Application outcomes, to meet department enrollment conversion goals. Address patterns of appointments outcomes: Not interested, re-scheduled or cancelled prospects/members.
Track/ensure timely, accurate completion & submission of enrollment Medicaid application outcomes.
Coordinate a synchronized workflow while maintaining the integrity of confidential information about prospective enrollees, as well as proprietary business information in collaboration with staff in Marketing, Relationship Coordinators, Intake RN, Intake Coordinators, Welcome Team Supervisors, and Referral Sources.
Conduct monthly audits established by yearly audit plan in the areas of Enrollment, Medicaid, and Customer Service surveys, tracking of Enrollment and Medicaid applications/documents.
Handle other duties as assigned with the occasional need to work weekends, on-call, additional hours before or after shift schedule and/or from other HF site locations.
Directs the Enrollment-Entitlement process by explaining features to callers, entering activities into proprietary Employee Medical Records system, responding to questions from enrollees/significant others and resolving daily routine problems including complicated cases.
Monitors Medicaid re-certification time frames for each active member and assists with completion of re-certification application.
Prepares monthly summary reports for Director/VP Operations to show status of re-certifications, Medicaid issues and applications.
Serves as a resource on Medicaid and other entitlement programs for Care Team.
Keeps up to date on Medicaid and other entitlement program issues and on changes in Medicaid/Medicare/HMO laws and shares information with Care Team Social Work and other Care Team members as appropriate.
Contribute to continuous performance improvements, this includes but not limited to monitoring staff effectiveness based on productivity, conversion of referral to enrollment, documentation, accuracy of data entry, and overall timeliness of the intake and assessment process.
Minimum Qualifications:
High school diploma or GED equivalent
Maintain a calm and even disposition even during the handling of crisis situations.
Ability to multitask and remain focused in an environment with distractions.
Follow protocols and use common sense to escalate situations to management and clinical staff appropriately.
Ability to be persuasive and establish credibility and trust along with positive and affable working relationships with direct reports, internal and external clients, etc.
Excellent communication skills, especially in one-on-one and small-large group settings and while interacting with prospective clients or customers to explain products/services are essential.
Experience exercising independent thinking, problem solving and achieving quotas/goals.
Must be able to discern diversified cultural differences and needs of assigned communities such as Spanish, Chinese, Russian, Creole, and Korean.
Aptitude for using a fast-paced proactive vs. reactive approach, maneuvering multiple tasks simultaneously including seamlessly changing priorities.
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.
EEO Law Poster and Supplement (http://www.dol.gov/agencies/ofccp/posters)
All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.
Hiring Range*:
Greater New York City Area (NY, NJ, CT residents): $67,205 - $95,680
All Other Locations (within approved locations): $59,800 - $87,360
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.