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About the role: The Medicare Outreach Agent executes SCFHP’s Medicare outreach and enrollment operations to grow SCFHP Medicare enrollment in compliance with all applicable state and federal regulatory requirements, SCFHP policies and procedures, and business requirements, and in support of organizational objectives.

Day to Day: Execute sales and outreach strategy to maximize membership growth, including meeting Medicare enrollment goals as well as individual sales and performance goals. Ensure timely follow-up on questions, issues and concerns from beneficiaries, members, providers, community partners. Organize and conduct sales presentations in the community and assist eligible beneficiaries to enroll, including conducting a needs assessment to best explain product offerings. Make outbound calls to follow up and close business; receive and manage inbound enrollment calls. Manage and execute outreach plan to providers and community based organizations to support achievement of Medicare enrollment objectives. Seek opportunities to improve SCFHP image/visibility in the community. Contribute ideas to increase retention and enrollment. Develop, maintain and use competitive analysis to inform outreach and retention efforts, including identifying and studying key competitors and their products, as well as related industry issues to maintain a personal awareness of competitive advantages and disadvantages; share the competitive analysis with the Marketing and Outreach teams. Stay current on SCFHP product and competing products; stay current on CMS Medicare Marketing Guidelines and with California specific Medicare-Medicaid Plans Medicare Marketing Guidelines. Successfully complete SCFHP required product and certification training; maintain California Life, Accident and Health Insurance License. Identify issues and trends (data, systems, beneficiary, member, provider, other) as well as general departmental questions/concerns and report relevant information to management; make recommendations. Address member questions, concerns, grievances, appeals or requests for services in accordance with policies and procedures, including appropriate documentation and communication with other departments. Assist with new hire training by having new hires shadow, observe in the community, and listen to calls, in accordance with training guidelines and protocols. Observe new hires and provide feedback to the Department Manager.

About You: Associate’s Degree in a related field of study, or equivalent training/experience. Minimum two years of Medicare sales, Medicare benefits advisory work, or Medi-Cal eligibility advisory work experience. Strong presentation skills with intent to sell. California Life, Accident and Health Insurance License, or the ability to obtain within 60 days of employment. Self-directed with proven ability to assume responsibility, work independently, meet deadlines and prioritize with minimum supervision. Maintenance of a valid California driver’s license and acceptable driving record, in order to drive to and from offsite meetings or events; or ability to use other means of transportation to attend offsite meetings or events. Experience with, and understanding of, Medicare outreach and/or sales. Experience with managed care and Medi-Cal. Knowledge of current trends, practices, strategies, tools for outreach and sales, including customer relation management applications. Ability to establish and maintain effective working relationships with providers, community based organizations and program participants. Bilingual in Spanish, Vietnamese, Mandarin or Cantonese. Ability to work nights and/or weekends as needed.

About Us: Santa Clara Family Health Plan (SCFHP) is a local, community-based health plan dedicated to improving the health and well-being of the residents of Santa Clara County. Working in partnership with providers and community organizations, we serve our neighbors through our Medi-Cal and SCFHP DualConnect (HMO D-SNP) health care plans.