Manager Medicaid Outreach & Retention

Now hiring a Manager Medicaid Outreach & Retention

Manages the PHP Medicaid Outreach Team to ensure a focus on acquisition, retention, and member satisfaction initiatives. Objectively measures performance, diagnoses problems, assesses solutions, and creates improvement plans. Develops and maintains a coaching model used to track employees development and performance (quality, production, attendance, etc.) and gives feedback accordingly. Monitors program performance statistics and works closely with the Director to apply them in managing staff performance. Is available to the staff to answer questions, take escalated calls, and monitor performance measures Motivates and encourages representatives through positive communication and feedback. Interviews and supports the hiring process for work unit staff. Assesses member and prospective member contact venues to ensure safety and feasibility. Serves as the lead for development and implementation of customer and staff education materials. Responsible for intake, tracking and coordinating requests from governmental agencies (such as CMS and HCA) and key community advocates for information or research and directs such inquiries to the appropriate operational area or staff for responses. Monitors process to ensure that internal responses are accurate, complete, and timely. Oversees compliance with all policies and regulatory and contractual requirements.

How you belong matters here.

 

We value our employees' differences and find strength in the diversity of our team and community.

 

At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.

Why Join Us

• Full Time - Exempt: Yes
• Job is based Rev Hugh Cooper Admin Center. Albuquerque, NM
• Work hours: Days
• Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.

• Bachelors degree required or six years of experience in lieu of degree.
• Minimum of 5+ years within a supervisory or higher field.
• 10+ years experience in managed care organization preferably in Medicaid Plans and other dual eligible or long term care market products and programs.
• Requires 3-5 years customer service experience in health insurance, healthcare retention, community outreach or marketing. Additionally, healthcare claims processing, provider network, or other background in research and resolution of complex issues experience preferred.
• New Mexico State Presumptive Eligibility/Medicaid On-Site Application Assistance [PE/MOSAA] certification required or obtained within 90 days of hire.
• Excellent public speaking and presentation skills; demonstrated ability to communicate effectively in person, by phone and in writing to people with different culture and socio-economic backgrounds.
• Excellent PC Skills; MS Office/Windows required; database experience preferred; experience with integrated data management systems.
• This position requires expert writing, editing, proofreading, and organizational skills.
• Bilingual preferred
• Ability to travel within the State of New Mexico.
• Must be able to lift 35-70 pounds, packing, loading, event set up and take down regularly; frequent travel and occasional overnight stays.

 

• Administers performance management for the work unit to achieve positive department and organizational performance results. Conducts routine performance audits to ensure compliance with departmental, organizational, and regulatory policies and procedures. Develops collaborative coaching plans and delivers positive feedback to provide growth opportunities and mentoring to each team member.
• Conducts ride-alongs with staff to outreach events. Holds staff accountable for outreach goals.
• Organizes, facilitates, and participates in community outreach and customer education events effectively communicating program attributes, plan benefits, services available, product changes, and regulatory requirements to a variety of audiences resulting in prospects successful application to the appropriate program.
• Develops and conducts presentations and training to internal staff and external customers and stakeholders to ensure an accurate understanding of our products, compliance and policy requirements, sales processes, and brand /value proposition messages.
• Secures supplies and marketing materials used in outreach and enrollment activities. Projects positive organizational image to the public. Prepares education materials to include handouts, workbooks, evaluation forms, and visual aids, reviews materials for compliance and quality.
• Tracks and reports outreach activity for reports required by the Human Services Department and NCQA.
• Hosts, attends, and participates in departmental meetings as a means for receiving education and training on new policies.
• Must have own vehicle, a valid NM drivers license and maintain a good driving record.
• Must provide own transportation and be able to travel.
• If applicable - Working knowledge of Medicare Advantage Program.
• Other duties as assigned

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

Inclusion and Diversity
Our culture is one of knowing and respecting our patients, members, and each other. We capture this in our Promise and CARES commitments.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.

#PHP123

USD $51.41/Hr.

The compensation range for this role takes into account a wide range of factors, including but not limited to experience and training, internal equity, and other business and organizational needs.