This position performs telemarketing and appointment setting tasks associated with obtaining new members in the OneCare and OneCare Connect program by making outbound calls to prospective members, participating providers, community-based organizations, government agencies and other duties as assigned in order to assist in enrollment of new members. This will include the explanation of the OneCare and OneCare Connect benefits and coordination of services regarding Medicare and Medi-Cal services for individuals within these populations. This position performs outreach activities and attend cultural events/fairs within Orange County in conjunction with Sales/Marketing department. Also facilitates appointment setting and enrollment activities with Members and OneCare and OneCare Connect Community Partners in a timely, professional and courteous manner.
POSITION RESPONSIBILITIES:
- Provides assistance and education for enrollment purposes to potential members regarding OneCare and OneCare Connect program.
- Prepares and conducts telemarketing presentations to potential members and community agencies.
- Maintains documentation of member cases within the FACETS system.
- Conducts targeted outreach and training to community-based organizations, health networks, vendors, members and providers.
- Performs outreach to potential members and provide them with information about OneCare and OneCare Connect at cultural events/ fairs.
- Other duties or projects as assigned by management.
Required Skills
- Develop rapport, establish and maintain effective interpersonal relationships with internal and external contacts at all levels.
- Maintain accurate records and documentation. Prepare and provide effective orientations and educational presentations.
- Work with OneCare and OneCare Connect Community Partners to expedite the resolution of member concerns.
- Remain knowledgeable of the health plans and CalOptima’s benefit structure.
- Communicate clearly and concisely, both verbally and in writing, with individuals from diverse backgrounds.
- Speak, understand, read and/ or write a second language (Spanish or Vietnamese) in addition to English is required for all assignments.
- Have access to an approved means of transportation for work and travel to locations as necessary to meet the OneCare Connect business needs.
- Utilize and access computer and appropriate software (e.g. Microsoft: Word, Excel, Access) and job-specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position.
Required Experience
EXPERIENCE & EDUCATION:
- High School degree or equivalent required. Bachelor’s degree preferred.
- 1 year of telemarketing experience in a sales environment required.
- Possession of an active California Department of Insurance (DOI) license and renewal every two (2) years is required.
- Experience working with persons in a customer/member service capacity preferred.
- HMO, Medi-Cal/Medicaid and health services experience preferred.
- Contact informational systems experience preferred.
- Bilingual in English and in one of CalOptima’s defined threshold languages (Spanish or Vietnamese) is required.
KNOWLEDGE OF:
- Issues that face members with special needs, such as seniors and persons with disabilities.
- Principles and techniques to serve the SPD population in diverse social and ethnic groups.
- Principles and practices of health care service delivery and managed care, Medi-Cal/CalOptima eligibility and benefits.
Grade: K
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