Job Description

Enrollment Agent

The purpose of the Enrollment Agent role for PruittHealth Premier is to serve as a licensed insurance agent to explain Plan benefits and answer the questions of potential members or their responsible party. Their role is to identify potential membership leads and help ensure timely outreach to assist with enrollment to the health plan. In addition, they provide ongoing marketing support to our in-network skilled nursing facility staff, conduct facility and community marketing events, and provider education both in our skilled nursing facilities and in our communities to support both our I-SNP and D-SNP as needed.

Key responsibilities include serving as a licensed insurance agent to explain Plan benefits and answer potential member resident/responsible party questions, coordinating with sales leadership to effectively enroll residents into institutional special needs plans (ISNPs); and dual special needs plans (DSNPs), working effectively with sales administration management for as-needed enrollment admin support, successfully utilizing sales closing skills to drive enrollments, maintaining a strong sale close rate, properly following established sales policies and standard operating procedures, effectively utilizing and updating company systems and databases, including systems for entering referrals and enrollments, ability to learn and carry out Centers for Medicare & Medicaid Services rules and regulations, meeting with potential members/responsible party to ensure that any questions are answered, existing benefits are compared to plan benefits and to act as a point of contact if the potential member or their family needs assistance during the enrollment process, offering to participate in facility events for marketing of the plan in accordance with CMS guidelines, sending monthly lists of upcoming enrollees to facility contacts, agency contacts prior to month end, ensuring that all interactions with the member are compliant with CMS regulations, conducting monthly facility audit in accordance with monthly checklist provided, and the Enrollment Agent will be responsible for a geographic territory of participating nursing facilities and counties for D-SNP marketing and enrollment within that same territory if applicable.

Knowledge, skills, and abilities include strong technological skills to connect with potential members/families interested in enrolling, ability to maintain health insurance licensure and Continuing Education Requirements set forth by licensing state, comfortable/patient in communicating via web-based video platforms, assertive self-starter who is able to influence others, strong written and verbal communication skills with abilities to deliver presentations in an impactful manner, proven ability to work independently and productively, strong computer skills and proficiency in Microsoft Office Suite products, willingness to travel to local meeting places as needed, substantial sales experience, knowledge of Medicare/Medicaid and/or nursing community dynamics, demonstrate compliance with CMS regulations regarding Medicare Advantage Plans and PruittHealth Code of Conduct, demonstrate exceptional interpersonal skills with ability to work independently as well as with a team, exceptional organizational skills: strong written and verbal communication and clear-thinking skills with the ability to synthesize complex issues into simple messages, willingness and ability to travel to facilities within your assigned region; have dependable transportation, a current driver's license, a clean driving record, and proof of insurance, have suitable home workspace allowing for productive office environment, understands the PruittHealth Premier Plan benefits, PruittHealth Premier Plan policies, procedures and articulate them effectively to providers, potential members and key decisions makers, and complete annual Medicare Fraud, Waste and Abuse Training and Model of Care Training.

Minimum education required is a Bachelor's degree. Minimum experience required is 2 years health insurance sales experience preferred. Good communication skills and organizational skills needed. Ability to professionally present plan benefits and financial information. Minimum licensure/certification required by law is Life & Health Insurance License. Additional qualifications (preferred qualifications) include AHIP Certification and Licensed to sell Life and Health insurance in required states to act as an enrollment agent if necessary.

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As an Equal Employment Opportunity employer, all qualified applicants will receive consideration without regard to race, color, religion, sex, national origin, disability, or veteran status.

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