Outreach and Retention Associate

Job Description

Posted Monday, December 2, 2024 at 5:00 AM

Centers Plan for Healthy Living's goal is to create the ultimate healthcare experience that provides our members, their families, healthcare decision makers, and general caregivers with the guidance and plans they need for healthy living.

Outreach and Retention Associate (ORA)–Medicare Advantage

CPHL is a Medicare Advantage Prescription Drug plan serving Medicare eligible beneficiaries living in the 5 boroughs of New York City, Erie and Nassau County.

If you are a professional, self-motivating, NYS DFS licensed producer*, CPHL has an excellent opportunity for you to advance your career.

This position is responsible to provide a concierge experience to our members by providing new members additional education and helping them access the benefits that they enrolled for, The ORA role will assist with services post-sales and add to the members satisfaction thus, ultimately reducing member’s cancellations and dis-enrollments.

The ORA ensures that new members understand plan details and which options they are eligible for, answers inquiries related to all CPHL products, Conducts Disenrollment Surveys and documents resulting actions and comments.

In addition, the ORA’s role will also be to generate leads, assign appointments and document Scope of Appointment eligibility via the ORA hotline.

• Conduct Outreach calls to existing MLTC members and generate leads to the MA unit
• Conduct Outreach calls to all prospect leads generated via marketing or lead purchase mediums
• Assign prospective appointments to Licensed Benefits Advisors when applicable
• Daily outreach to new members to reeducate them and orient them on the CPHL benefits and health delivery system access.
• Conduct daily surveys to members who have submitted a dis-enrollment request and document the reasons.
• Conduct weekly member education over the phone, at their home and/or in the field i.e. COV and Events.
• Set up PCP appointments and assist with logistics such as OTC and Transportation benefits
• Assist members with Medicaid Eligibility when warranted by working and coordinating with key departments
• Ensure potential members understand plan process and access details and options they are eligible for,
• Answer inquiries related to all CPHL Medicare products
• Educate potential members about Medicare Advantage/ Special Needs Plans and the benefits of enrolling in the CPHL plan that will meet their needs best
• Conduct Plan to Plan Changes
• Informs potential members about OEV calls and/or letters.
• Take Scope of Appointment calls from the field and document them.
• Coordinate and assist in re-enrollment and plan changes applications.
• Refer escalated inquiries to Management.
• Reduce monthly dis-enrollments and maintain a low and acceptable rate 10% or better
• Adhere to all CMS, CPHL and departmental rules and regulations.
• Develop and maintains knowledge of products, services and systems as required.
• Perform other duties as required.

• High School Diploma.
• A NYSDFS Accident and Health is preferable*.
• Minimum 2 years of sales and/or customer service experience, preferably with Medicare.
• Excellent communication and presentation skills.
• Demonstrated PC literacy.

CPHL is an Equal Opportunity Employer, and we are committed to expanding our talented and diverse team.

Centers Plan For Healthy Living is committed to leveraging the diverse backgrounds, perspectives and experiences of our workforce to create opportunities for our employees and our business. We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or any other characteristic protected by law and will not be denied employment.