Enrollment and Recertification Specialist

Amida Care, the largest Medicaid HIV Special Needs Plan in NY, delivers a uniquely effective care model that has become a true benchmark for innovation, engagement and member health outcomes. Our mission is to provide access to comprehensive care and coordinated services that facilitate positive health outcomes and general well-being for our members. This true integrative care model addresses psychosocial, housing, behavioral and medical services directly evolving around the needs of each member. 

We are a community of individuals from diverse peoples who work together to actively foster a fair, equitable, inclusive environment where all employees receive an invitation to belong. Visit http://www.amidacareny.org for more information about the Amida Care culture.

We are actively seeking a highly motivated, innovative and experienced individual to join our team as the Enrollment and Recertification Specialist. Compensation will be commensurate with experience.

Position Summary:

The position is responsible for assisting prospective members with enrolling into Amida Care’s Special Needs Plan and assisting current members with their Medicaid recertification applications by phone and in-person as needed. They serve as a subject matter expert for Amida Care’s Managed Care Plan and Services; and, responsible for closing enrollment leads.  This position includes both in-house and external outreach efforts to current and prospective members as directed.

Responsibilities:

• Outreach prospective members received as a lead and /or other sources defined by management.
• Educate and assist prospective members with enrollment in the Amida Care plan in accordance with the New York State Marketplace guidelines, via phone or in person, as directed.
• Attend member and community events as needed. This includes events held during non-traditional work hours and weekends. 
• Conduct outreach calls to existing members to assist with recertification process based on departmental protocols, to achieve weekly and monthly productivity goals.
• Explain benefits and services offered by Amida Care as requested or needed when assisting members with recertification.
• Conduct off-site visits for members who need and/or request assistance with recertifying, including working on Amida Care’s Recreational Vehicles (RV), when directed.
• Accurately document all member recertification, and enrollments via designated tools including Salesforce, email, and other tools as assigned by management.
• Ensure that all recertification, enrollment and field activities are performed in compliance with Medicaid regulations and corporate policies.
• Perform all activities in a timely, effective, and efficient way to sustain membership.
• Maintain required equipment/ supplies as needed and in working order (i.e. business cards, laptop, brochures etc.). 
• Report and address issues with laptops, phones and other tools immediately, within an hour of discovering issue.
• Report all incidences, including those immediately resolved and those requiring investigation and follow-up management based on established protocols.
• Perform other duties as assigned.

Amida Care is Diversity, Equity and Inclusion employer committed to full inclusion and elimination of discrimination in all its forms. We strive to develop, promote and sustain a culture that values equity and leverages diversity and inclusiveness in all that we do.  

EDUCATION REQUIRED

• High School Diploma.

EXPERIENCES AND/OR SKILLS REQUIRED

• Two (2) years of relevant work experience.
• Prior health plan (Medicaid-Manage care) experience, preferred. 
• Must be able to travel and work in all five (5) boroughs of New York City as needed. 
• Must be able to work flexible schedule as needed.
• Excellent interpersonal and presentation skills, multitask. 
• Demonstrate computer proficiency in Microsoft Office (Word, Excel, and PowerPoint).
• Exhibit ability to learn and work with user-centric electronic systems and tools including a laptop and mobile phone.
• Demonstrate understanding and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts.
• Demonstrate appropriate behaviors in accordance with the organization’s vision, mission, and values.

* New Hire must Complete the Certified Application Counselor Training (CAC) (within two months of hire) with New York State of Health Marketplace and subsequent completion of annual CAC Training; Certified CAC’s required.