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Medicare Sales Representative II

This job posting is no longer active.

2507 Delaney Ave
Wilmington, NC
Job ID: 9870
Date Posted: Sep 30, 2022

Job Description

Description

About NHRMC

NHRMC, established in 1967 in Wilmington, NC, is recognized as a preeminent healthcare organization focused on leading our community to outstanding health. We have an 855 bed network of hospitals and multi-specialty physician group practices with more than 200 physicians. With a network of primary, specialty, neighborhood clinics and regional medical centers; you will find our culture is the very definition of best in practice. Join us and find out how many ways NHRMC offers you the chance to focus on what really matters - our patients and community.

About the Job

Location: New Hanover Health

Department: New Hanover Health

Full Time Equivalent: FTE: 1.000000

Work Type: 64 to 80 Hours Pay Period

Work Schedule: STD HRS - Standard-Exe or Office w flex

Exempt from Overtime: Exempt: Yes

What You'll Do

Summary:
The Marketing/Sales and Community Outreach Representative is responsible for driving sales performance for health plan products, including New Hanover Health’s Medicare Advantage product. This Representative is responsible for developing strategic sales goals and initiatives and for meeting monthly and yearly goals while ensuring that company employees and outreach staff remain in compliance with all state and Centers for Medicare and Medicaid Services (CMS) regulations.


Responsibilities:
Job Responsibility: Assures department efficiency and effectiveness

1) Develop outreach and marketing strategies in collaboration with additional departments to facilitate compliant lead generation strategies in the market

2) Connect with current and potential members to ensure continued engagement through positive consumer experiences

3) Facilitate service recovery efforts when necessary to ensure member retention

4) Actively engage with stakeholders in the community to elevate the New Hanover Health brand

5) Collaborate with providers to develop CMS compliant marketing strategies

6) Develop and maintain positive working relationships with strategic and support departments in a structured corporate environment

7) Develop, implement, manage market strategies to provide value-based care to new members in cooperation with other members of the leadership team, consistent with State and Federal regulations

8) Communicate job expectations to employed sales staff and outreach coordinators

9) Plan, assign, monitor, and appraise employee sales performance to achieve budgeted monthly and annual enrollment goals

10) Develop, implement, and enforce policies and procedures
11) Implement proactive measures to monitor team while coaching staff on improved ongoing performance

12) Set example of proper behavior and accountability to employees and serve as a role model for what is expected of a New Hanover Health representative

13) Maintain daily availability with all employees via cell phone and email

14) Coordinate with other departments as needed

Time Spent: 35%

Expected outcomes:
• Production levels are achieved
• Federal, State and organizational compliance maintained at all times
• Policies and procedures updated annually (more often if necessary)
• Staffing maintained at an adequate level and receive appropriate training to perform job
• Employee issues (performance, behavior, compliance, etc.) are addressed timely and appropriately in accordance with company policies
• All employees have materials required to complete job duties
• Oversight files are maintained in compliance with CMS requirements
Job Responsibility: Establish and implement plans and processes to meet monthly and yearly sales goals

1) Develop, assemble, and manage internal and external leads

2) Provide internal and external education and guidance on managed care products, including Medicare Advantage

3) Drive the performance of the sales team

4) Take part in the strategic planning and execution of marketing sales initiatives

5) Implement strategies to meet determined sales goals

6) Train, orient, mentor and evaluate staff

7) Aid senior management in benefit & product design on an annual basis for all products using market research and knowledge

Time Spent: 30%

Expected Outcome(s):
• Monthly and yearly sales and outreach goals are met
• Sales agent development goals met
• Daily, weekly, and monthly reporting of all sales activity
• Staff have specific goals and objectives
• Department sales and strategies regularly reported


Job Responsibility: Oversight of internal and external agents and broker channels

1) Monitor internal and/or external agent and outreach coordinator performance and compliance

2) Coordinate oversight and contracting activities

3) Monitor, respond to, and report on sales allegations

4) Ensure brokers complete thorough follow through of all internal leads

Time Spent:20%

Expected Outcome(s):
• Appropriate lead distribution
• Policies and procedures updated annually (more often if necessary)
• Enforce contract requirements and update contracts as necessary
• Agents receive timely and accurate payment
• Disenrollment rate remains at company specified level
Job Responsibility: Ensure compliance with CMS and State regulations

• Coordinate with compliance department to ensure sales agents and outreach coordinators are compliant with CMS and State marketing and sales regulations

Time Spent: 15%

Expected Outcome(s):
• Policies and procedures updated annually to remain in compliance with regulatory guidance (more often if necessary)
• Monitoring and tracking of sales enrollments and un-enrollments
• Participate in CMS and State training as required
• Compliance issues reported as necessary

Position Requirements

Credentials:
* NC Life&Health Producers Licen
* AHIP Medicare Advantage Cert

Education:
Essential:
* Associate Degree

Other information:
1. Education: Bachelor degree preferred.
2. Licensure & Certification: Current North Carolina Life and Health Producers License, including long term care license. AHIP Medicare Advantage Certification.
3. Experience: 2+ years in direct Medicare Advantage and Commercial Health Plan Sales OR 2+ years in managed care, health insurance, and/or health services related sales OR 2+ years of direct management experience of a performance-based sales team preferred.
Demonstrates standards of performance (ownership, teamwork, communication, compassion) that support patient satisfaction and principles of service excellence.
Performs other duties as assigned.
Individual will possess commensurate combination of education, experience and qualifications.


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