Bilingual Sr Retention Advocate

The Sr Retention Advocate is responsible to educate and provide Healthfirst members support in obtaining financial entitlements for which they are eligible. This enables members to maintain the highest level of independence both at home and within their communities. Education within Medicare the Medicare Savings Program (MSP) assist our members in applying and continuous follow up to eligibility. S/he will be responsible for a longer cycle of work.

Working under the direction of the Entitlement Manager and Team Lead maneuvers multiple tasks independently with a fast paced proactive vs. reactive approach to changing priorities. Frequently communicates moderately complex information and interacts through electronic documentation tools. This is a paperless work environment requiring daily handson administration of multiple electronic Patient Health Information (PHI) databases and security requirement tools such as encryption. These systems include but are not limited to TrucareHTML5 RightFax VoIP Virtual Work Platforms (VPN) creating pdf files (Adobe Acrobat) and MS Office 360 software (such as Word Excel and Outlook) Interaction Client Jabber etc.

Duties & Responsibilities:

Contact member or primary caregiver by phone or letter to arrange a telephonic or in person interview to assess Medicaid/Medicare/Medicare Savings Program eligibility. Ensures all calls are in accordance to approved Healthfirst scripts

Has full and complete access to patient records and reports as well as to personal/financial profiles and documents always calling for the utmost integrity

Serves as an advocate between all parties maximizing the participants support network and obtaining needed services

Research ePACES and/or Marx for Medicaid and Medicare eligibility exclusion and exemption codes

Consult with Human Resource Administration (HRA)/Local Department of Social Services (LDSS) Medicaid staff as needed and report to supervisor any need for HRA/LDSS consultation

Track the Medicaid/Medicare/MSP status for all members on an ongoing basis until all member entitlements are gained

Completes Medicaid/MSP application in a timely organized fashion and assists participant or primary caregiver in the completion of the application

Assists in collecting all required documents for applications

Submit documentation to HRA/LDSS within specified timeframe to assure Medicaid coverage for participant

Monitor all applications according to HRA/LDSS/Social Security office/Medicare time frames

Documents all client calls /outcomes in database system and spreadsheets

Responsible for prolonged cycles of work must maintain accurate data and be able to present it and follow up promptly

Prepare/submit monthly reports to Management

Ongoing Knowledge & Support:

Keep up to date on changes in Medicaid/Medicare/HMO laws and shares information with other Team members as appropriate

Participate in relevant entitlement training/meetings

Engage in mastering the divisions impact on Healthfirst and its members

Contribute creative solutions and ownership of daily assignments for seamless communication and systematic completion of routine and special projects

Maintain the highest level of integrity courtesy and respect while interacting with clients employees and business contacts

Assists with orientation of new Hires so they understand the model support enrollment growth and can answer routine questions about the program.

Handle other duties as assigned with the occasional need to work weekends additional hours before or after shift schedule and/or from other HF site locations

Experience managing member information or appointments in a shared network environment using paperless database modules

Minimum Education: High School diploma or GED

Prior experience with Medicaid /Medicare/Medicare Savings Program

Experience in inbound and outbound call center within a healthcare environment

Have access to a vehicle and be able to travel throughout the 5 boroughs Westchester Orange Sullivan Rockland and Nassau County

Well organized detail oriented and bale to adapt to procedural and other business information changes

Strong data entry skills must be able to maintain monthly spreadsheets for tracking and statistical purposes

Must Speak Mandarin/Cantonese Spanish or Haitian/Creole.

Preferred

Associate degree from an accredited institution

Prior experience working with the frail adult or elderly population

A solid understanding of the value of integrated care

Experience in health insurance home care environment acute subacute longterm care (LTC) setting or managedlong term care (MLTC)

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. HF Management Services LLC complies with all applicable laws and regulations. Applicants and employees are considered for positions and are evaluated without regard to race color creed religion sex national origin sexual orientation pregnancy age disability genetic information domestic violence victim status gender and/or gender identity or expression military status veteran status citizenship or immigration status height and weight familial status marital status or unemployment status as well as any other legally protected basis. HF Management Services LLC shall not discriminate against any disabled employee or applicant in regard to any position for which the employee or applicant is otherwise qualified.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment please contact us by sending an email to or calling. In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within HF Management Services LLC will be reviewed at the email address and phone number supplied. Thank you for considering a career with HF Management Services LLC.

Know Your Rights

All hiring and recruitment at Healthfirst is transacted with a valid @ email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @ or not one of our recruitment partners please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.

Hiring Range*:

• Greater New York City Area (NY NJ CT residents): $57408 $76960

• All Other Locations (within approved locations): $49795 $72800

As a candidate for this position your salary and related elements of compensation will be contingent upon your work experience education licenses and certifications and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary Healthfirst offers employees a full range of benefits such as medical dental and vision coverage incentive and recognition programs life insurance and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in good faith would pay to a new hire or for a job promotion or transfer into this role.