Job Description

Job Description

Job Description

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The Company:

AlohaCare is a local, non-profit health plan serving the Medicaid and Medicare dual eligible population. We provide comprehensive managed care to qualifying health plan members through well-established partnerships with quality health care providers and community-governed health centers. Our mission is to serve individuals and communities in the true spirit of aloha by ensuring and advocating access to quality health care for all. This is accomplished with emphasis on prevention and primary care through community health centers that founded us and continue to guide us as well as with others that share our commitment. As Hawaii’s third-largest health plan, AlohaCare offers comprehensive prevention, primary and specialty care coverage in order to successfully build a healthy Hawaii .

The Culture:

AlohaCare employees share a passion for helping Hawaii’s most underserved communities. This passion for helping and caring for others is internalized and applied to our employees through a supportive and positive work environment, healthy work/life balance, continuous communication and a generous benefits package.

AlohaCare’s leadership empowers and engages its employees through frequent diversity, recognition, community, and educational events and programs. AlohaCare has a strong commitment to support Hawaii’s families and reinforces a healthy work/home balance for its employees. Because AlohaCare values honesty, respect and trust with both our internal and external customers, we encourage open-door, two-way communication through daily interactions, employee events and quarterly all-staff meetings. AlohaCare’s comprehensive benefits package includes low-cost medical, dental, drug and vision insurance, PTO program, 401k employer contribution, referral bonus and pretax transportation and parking program.

These employee-focused efforts contribute to a friendly, team-oriented culture which is positively reflected into the communities we serve.

Position Summary:

The Medicare Sales Agent carries out sales strategies and activities to meet sales goals and serves as a subject matter resource on Medicare sales. The Medicare Sales Agent performs sales activities, including telemarketing, one-on-one meetings, group presentations, community and provider education sessions, lead follow up, re-enrollment, referrals and re-marketing opportunities in a CMS-compliant manner. Ensures submission of timely, accurate, and complete enrollment applications that meet CMS requirements. Supports development and maintenance of community partnerships, including Co-Branding efforts in partnership with the Marketing and other departments. The Medicare Sales Agent represents AlohaCare in a highly professional and ethical manner consistent with organizational values and branding objectives.

Primary Duties & Responsibilities:

Medicare Sales

• Answer Inbound and make outbound calls to pre-qualified prospective Medicare members.
• Answer Inbound Member Retention calls to educate members on their plan benefits.
• Carries out CMS-compliant strategies and activities to meet goals stated in the current AlohaCare Medicare Sales Business Plan.
• Serves as a subject matter resource on Medicare sales.
• Supports development and execution of member, staff and community Medicare educational efforts.
• Supports development and maintenance of organizational partnerships, including co-branding efforts.
• Supports branding consistent with organizational goals.
• Supports department participation in organizational-wide efforts such as open enrollment, CMS audits, quality initiatives, NCQA accreditation, MQD contract readiness and other activities.
• Supports production of reports including fulfillment of regulatory requirements and organizational needs.
• Contributes to the development and execution of Medicare related communication products, including marketing materials, surveys, directories, manuals, handbooks, website, newsletters and advisories.
• Seeks and shares industry information that informs AlohaCare of current issues in the health industry and communities we serve.
• Represents AlohaCare at external events including exhibit booths, conference and meetings.
• Supports inter-departmental collaboration for projects, process improvement, member transitions and retention activities and on-going operations.
• Responsible for maintaining AlohaCare’s confidential information in accordance with AlohaCare policies, and state and federal laws, rules and regulations regarding confidentiality. Employees have access to AlohaCare data based on the data classification assigned to this job title

Regulatory Compliance

• Complies with all Medicare, Medicaid and applicable federal, state and AlohaCare requirements.
• Complies with all applicable AlohaCare policies and procedures.

Required Competencies & Qualifications:

• High school diploma or equivalent
• Minimum of 2 years sales experience which includes a minimum of 1 year Medicare Insurance Sales experience.
• Current State of Hawaii, Life and Health Resident Producer License.
• Current AHIP Medicare Sales Certification/Recertification.
• Current valid Hawaii driver’s license and access to an insured vehicle.
• Professional and positive attitude.
• Strong verbal and written communication skills, including public speaking and interpersonal interaction.
• Flexible and adaptable to changing priorities
• Working knowledge of Microsoft programs: Word, Excel, Outlook and PowerPoint
• Ability to think critically
• Ability to work effectively with a wide range of audiences, including beneficiaries, businesses and community organizations.

Preferred Qualifications:

• Knowledge of Medicare and/or Medicaid programs.
• Knowledge of health plan operations
• Experience with healthcare laws, regulations and standards, including CMS Medicare Marketing Guidelines and HIPAA (Health Insurance Portability and Accountability Act).
• Ability to understand and speak a second language (preferably but not limited to Ilocano, Tagalog, Korean)
• Event planning experience

Physical Demands/Working Conditions:

• Indoor and occasional outdoor working conditions
• No environmental hazards.
• Sedentary Work: Exerting up to 20 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met.
• Requires on-island vehicular travel & occasional inter-island travel with overnight stays, as well as working occasional evenings and weekends.

Salary Range $23.00 - $28.00 an hour

AlohaCare is committed to providing equal employment opportunity to all applicants in accordance with sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record), disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military/veterans’ status, or other characteristics protected under applicable state and federal laws, regulations, and/or executive orders.

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