Account Specialist AR-ES-FR

Where: New York (United States)

Extent of Work: Full Time

Click here to apply in English

Click here to see other job offers in Arabic, Spanish, French

  • Responsible for membership growth in strategic target areas
  • Identifies potential members and designs a plan to educate potential members regarding the health benefits and care that is tailored for the member  as well as provide information  regarding the particular plan’s features and benefits.
  • For existing members, will review current benefits to determine appropriate plan, assist with recertifying their existing coverage or suggest transfer to alternative plan that is better aligned for their care. Will provide guidance and assistance to  recertify the member’s  healthcare coverage for Medicaid, CHP, EP and QHP,  Medicare or Complete Care as well as  adding on additional eligible family members
  • Work collaboratively within a team to identify and develop business within  assigned territories
  • Discretion in choosing which providers to visit and the number of visits each day.
  • Partner with Community Engagement in order to organize events within the sales territory, including but not limited to health fairs, parades, holiday-themed events, trade show expos, hospital orientations, provider sponsored events  as well as  health-related theme events.
  • Responsible for scheduling  face to face meetings with Hospitals, IPA’s, FQHC’s and community providers to identify issues and ensure plan visibility. Alert DSE of  claim/rate related issues and  follow up with the results
  • Establish and maintain relationships with local community organizations to promote HF benefits in the community
  • Advance Healthfirst through superior customer service focused in an assigned territory, which will help optimize provider and member satisfaction
  • Conduct Provider portal orientation for new providers; educate the practice on how to navigate the provider portal (member eligibility, authorization, claim look up, membership roster, quality reports) to solidify the business relationship with providers and to support quality score improvement
  • Provide leads to DSE on new provider recruitment to diversify our network (FQHC, Dental, Pharmacy, Hospital, IPA, community providers)

Minimum Qualifications:

  • A Valid Drivers License
  • New York State Life Accident ( optional) & Health License (Mandatory)
  • Associate degree with experience in one of the following:  sales, marketing, provider relations
  • 3 years of sales experience (1 year in health insurance industry)
  • Knowledgeable and experience working with provider network/hospital
  • Bilingual-English and one or more of the following: Yoruba, Twi, French, Wolos, Arabic, Spanish
  • Excellent communication & interpersonal skills (Oral & Written)
  • Good computer skills & tech savvy (Microsoft Office)

Preferred Qualifications:

  • Bachelor’s Degree from an accredited institution
  • Account management experience
  • Medicaid and/or Medicare managed care experience

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