Outreach Retention Specialist

US-NY-New York
Requisition ID
Department Name
PHSP Facilitated Enrollmt


Healthfirst is a not-for-profit managed care organization sponsored by some of the most prestigious and nationally recognized hospitals and medical centers in New York. We are one of the fastest growing health plans in our area with over 900,000 diverse members and a network of more than 24,000 providers and 3,400 employees.


Our mission is to ensure that our members have superior healthcare and satisfaction; we significantly improve the health and wellness of the New York metropolitan area, all while driving down the costs. Employees shape our company and connect us to our communities. We look to recruit and retain intelligent, driven leaders who are passionate about healthcare and embody our five culture drivers:

  • Dream Big, Plan Wisely
  • Break Down the Walls
  • Think Critically, Speak Up, Deliver with Pride
  • Inspire Through Trust, Lead By Example
  • Be Unstoppable

Position Summary:

The Outreach Retention Specialist maintains current Medicaid, QHP, EP and CHP membership by educating and assisting current members in the completion of the renewal process. Marketplace Retention Specialists may also educate and enroll potential members into QHP, EP and CHP. All potential members for Medicaid enrollment must be referred to a Marketplace Facilitated Enroller.


Position Details:

  • Our main office is located at 100 Church Street (downtown Manhattan)
  • Our next 10-day paid training starts October 23, 2017 from 9am to 5:30pm from Monday through Friday
  • Work Schedule: Monday through Friday, 9am to 5:30pm
  • Work Location: 16 Court Street in Brooklyn
  • Salary: high 40's to low 50's depending on related experience
  • Benefits: Medical, Dental, Vision, Basic Life & Accident Insurance, Flexible Reimbursement Accounts, Employee Assistance Plan, Commuter Benefit, Healthfirst 401(k) Plan plus much more! 


Duties and Responsibilities:

  • Educate members on all aspects of the plan including answering questions regarding plan’s features and benefits. Responsible for identifying and assisting current members who are due to recertify their healthcare coverage for Medicaid, QHP, EP and CHP by completing member’s annual recertification application including adding on additional eligible family members. Assist potential members by educating individuals and families on the benefits of Healthfirst for QHP, EP and CHP products. Assist members with selecting a Primary Care Physician (PCP) using the Healthfirst provider directory on their BlackBerry device. Maintain adequate Book of Business (BOB) at all times, while adhering to the BOB policies and procedures.
  • Conduct outbound phone calls to existing members whose renewal date is approaching.
  • Assist member with renewing coverage telephonically to ensure continuity of coverage and support organizational growth goals.
  • Complete daily enrollment, call statistics and reach rate reports for management.
  • Responsible for meeting renewal goals and maintaining acceptable rejection levels while adhering to regulatory and state compliance.
  • Recertification activity includes on site coverage at hospitals, provider offices and Community Based Organizations (CBO’s).
  • Complete all new enrollments for QHP, EP and CHP through the NYSOH Marketplace.  Submit complete applications to manager at a minimum of three times per week using required Application Submission Forms (ASF) and batch forms.
  • Review rejections and update renewal applications accordingly for resubmission to management.
  • Refer prospective clients to on site Facilitated Enrollment representatives or Medicare Representatives when conducting recertification business at provider offices, hospitals and other external locations. Retention Specialists are prohibited from pre-qualifying a potential member.
  • Arrive at scheduled work site, team meetings, training sessions and events in a timely manner. Clock-in and clock-out using the Teletime system as required.
  • Participate in weekly, bi-weekly and monthly staff meetings and trainings including one-on-one meetings with management and Field Trainers (FT). Provide information to management on opportunities at current or potential marketing sites. Raise any issues / concerns to management relative to site coverage, competition, training needs and process improvement.
  • Remain knowledgeable of competitor’s products, marketing practices and keep management informed of such products and practices.  
  • Provide recommendations on process improvement. Advise management of any recommendation that can make a workflow or process more efficient.


 Minimum Qualifications: 


  • Must have a High School Diploma or GED from an accredited institution
  • Customer service, sales, or call center related work experience
  • Ability to work in a fast paced and changing work environment


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