Medicare MAP Advisor

Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families, healthcare decision makers, and general caregivers with the guidance and plans they need for healthy living.
JOB SUMMARY: The Medicare MAP Advisor- Will promote and sale MAP and Medicare Line of Business, maintains relationships, services our existing customers and secures new customers by consultative selling/marketing and performing all required tasks assigned by the Sales Field Manager.
Incumbent will be responsible for educating and enrolling potential beneficiaries by explaining program benefits in a manner that is compliant with Center for Medicare and Medicaid Services (CMS) and company policies and regulations.
The Medicare MAP advisor will develop a presence in the community and serve as a point of contact for our current members.
MAP Advisor Primary Responsibilities: • Educate prospects on CPHL MAP product designed for Full Medicaid and Medicare recipients that need in home care and Long-term care services, • Care Managers who will manage day to day needs, • Care adjustment 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 • Developing and maintaining relationships, leads and new business.
• Being 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 • Ensure prospects to be enrolled properly and all internal external processes are followed • Update customer file in Case Tracker with summary of interaction • Interact with internal departments to ensure meeting deadlines for all documentation requirements.
• Have a relationship with LHCSA’s • 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.
• Submits daily Plan of Action, 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.
Territory Management • Maintain CPHL MAP and Medicare Advantage Plan visibility in the community by monitoring multiple marketing locations and events.
• Requires the ability to carry marketing table, materials, give-away items and boxes.
• Requires a proactive approach to searching for additional marketing locations while adhering to company regulatory guidelines.
Compliance • Requires continues education to stay abreast on all recent changes in regulations, recent training sessions, changes in workflow and changes to company benefits.
• Must score favorably in all post and on-going quizzes, refresher training and administrative audits.
• Must be prepared when summoned by the Special Investigation Unit.
Technology • Must be able to adapt to various software used by CPHL, maintain an electronic book of business, research participating providers, and communicate with internal departments via Microsoft Outlook.
• Is responsible for safeguarding all equipment issued by Centers Plans for Healthy Living MAP and Advantage Care Medicare HMO Plan.
Enrollment application process • 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).
CCustomer Service • Ensures any/all concerns are addressed and resolved within a reasonable time frame and/or directed to the appropriate party.
Retention • Ongoing communication outreach to membership; including but not limited to 30, 60, 90 day outreach to ensure member satisfaction.
Other Duties and Responsibilities • Keeps management abreast on any recommendation 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.
• This is a field-based position.
Incumbent must be willing to travel throughout the five (5) boroughs, as needed) on a daily basis.
Knowledge and Skills: Required: Preferred: • Bilingual with English as a primary language • 3 plus years of, Medicare or Sales experience.
• Valid Driver's License and access to personal vehicle Type of Experience Certifications/Licensure: Active NY Health & Accident License Preferred: 3 plus years of, Medicare or Sales experience 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.
The above statements are intended to describe the general nature and level of work performed by individuals assigned to the job classification.
They should not be construed as an exhaustive list of all responsibilities, duties and skills required.
Centers Plan For Healthy Living is committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our employees and our business.
We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law and will not be denied employment.