Sales Representative I - Bronx (Bilingual French/Wolof)
Location: Jersey City
Posted on: September 17, 2023
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
MetroPlusHealth 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,
MetroPlusHealth's network includes over 27,000 primary care
providers, specialists and participating clinics. For more than 30
years, MetroPlusHealth has been committed to building strong
relationships with its members and providers to enable New Yorkers
to live their healthiest life. Position OverviewThe Sales
Representative is responsible for educating and assisting qualified
individuals with purchasing affordable health insurance coverage
and/or obtaining an eligibility determination for coverage in
Qualified Health Plans (QHPs) and insurance affordability programs
such as Medicaid and Child Health Plus (CHP) through the NY State
of Health (MarketPlace). The Sales Representative is responsible
for identifying and educating prospective members that do not have
health insurance and/or are looking to change coverage as well as
assisting existing members with recertification and education of
benefits. The Sales Representative is tasked with performing all
duties in accordance with the Affordable Care Act (ACA) as well as
all other pertinent rules and regulations.This is a field position,
so while you may have a preference for a specific area, please note
that you may be deployed to a different area, based on the
organization's needs. Job Description Educational/Enrollment
- Educate and provide assistance to qualified individuals with
applying for coverage through the NY State of Health Marketplace in
a Qualified Health Plan (QHP) and insurance affordability programs
such as Medicaid and Child Health Plus.
- Assist consumers/applicants with calling the NY State of Health
Customer Services Department for assistance with enrolling and/or
providing verification documentation.
- Conduct public education activities for consumers to raise
awareness of available QHPs within the Marketplace.
- Explain potential eligibility for public/governmental programs,
how the federal health insurance premium tax credit and
cost-sharing reductions work, and outline potential risk factor, if
any, to consumers.
- Describe the features and benefits of health insurance
coverage, including cost-sharing mechanisms like deductibles,
co-pays, co-insurance and how these work and/or affect the
- Describe the different metal tiers within the Marketplace and
how the benefits may change at different tiers based on the
- Conduct presentations and participate in ACA forums and
workshops upon request.
- Assist consumers with submitting documents and information as
required by the Marketplace via scan, fax or mail.
- Assist existing members with recertification, when
- Assist consumers with the submission of premium payments when
- Securing and safeguarding confidential information to prevent
Protected Health Information (PHI) from being obtained from
unauthorized personnel to ensure compliance with privacy and
- Provide information in a manner that is culturally and
linguistically appropriate to the needs of the population being
served by the Marketplace.
- Participate in all trainings, updates and webinars and other
forums in which information is necessary to carry out roles and
- Mandated to meet the annual MFE recertification
- Keep abreast of all industry and regulatory updates as it
pertains to the ACA and Marketplace.
- Maintain discretion regarding business-related files, reports
and conversations within the provisions of applicable State and
Federal Statutes and regulations.Tactical
- Maintain a daily tracking tool that entails detailed rep
- Monitor all applications in personal dashboard to ensure timely
and accurate follow through from applicants.
- Conduct a daily review of personal dashboard to address and
follow-up on any and/or all potential leads for consumers seeking
- Maintain a consistent supply of various educational and product
- Keep abreast of all the Marketplace functionalities to
effectively manage individual accounts.
- Conduct a daily review of the MetroPlus "Marketplus" lead
management program to follow-up on all new potential enrollment
leads and consumer inquiries. Record all follow-up dispositions in
a timely and accurate manner.
- Data enter all applicant demographic, enrollment site and PCP
selection data in the required "Enrollment Program" within the
MetroPlus portal at the time of the initial enrollment
- All other tasks and responsibilities as may be required to
satisfy the expectations of the role. Minimum Qualifications
- Must have a High School Diploma or GED.
- Minimum of one (1) year of Sales/Customer Relations experience
- Must be in compliance with all conflict-of-interest standards
- Required to work evenings and weekends.Licensure and/or
- Must complete and pass the NY State of Health approved training
program and become certified. Must complete all required annual
recertification as a MFEProfessional Competencies
- Integrity and Trust
- Customer Focus
- Functional/Technical Skills
- Written/Oral Communications
Keywords: MetroPlusHealth, Jersey City , Sales Representative I - Bronx (Bilingual French/Wolof), Sales , Jersey City, New Jersey
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