Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.
Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
As a condition of employment, L.A. Care requires a COVID-19 vaccine. This requirement includes our remote workforce. If you would like to request an exemption, L.A. Care has implemented a process to consider exemptions, for documented medical conditions and sincerely held religious beliefs. L.A. Care will review all exemption requests prior to proceeding with the recruitment process.
The Enrollment Support Service (ESS) Representative I is responsible for facilitating targeted enrollment activities and increasing membership in Cal MediConnect, Medi-Cal, L.A. Care Covered, and L.A. Care Covered-Direct. The level I role is responsible for reaching minimum production goals establsihed for this level in the Sales Program. Daily activities for ESS Representative I include handling inbound phone calls for all lines of business and placing outbound phone calls as part of product growth initiatives. This role applies comprehensive understanding of products and benefits in order to help perspective members make enrollment decisions.
Inbound Call Inquiries and Enrollment Support:
Handles inbound phone queues appropriately. Responsible for maintaining call control to ensure that the phone queues meet all defined service levels. Ensures that there is appropriate phone coverage during the department's business hours. Maintains a high standard of customer service, product knowledge, and agent relationship management.
Outbound Product Education and Enrollment Activities:
Conducting outbound calls relevant to enrollment campaigns, requests for information from community events, provider offices, after-hour messages, and website inquiries. Providing back-up external event coverage for community health fairs and enrollment events.
Sales Data Management:
Ensures the integrity of data. Effectively utilizes the Customer Relationship Management (CRM) system to manage the sales referral pipeline and lead algorithm assignments. Enters Data accurately by following the Goldmine and QNXT guidelines. Responsible for maintaining the quality and integrity of the CRM database through constant training on upgrades on the CRM data database. Maintains a high proficiency of the internal and external systems. Demonstrates efficient use of internal proprietary systems, including but not limited to: CISCO, QMEIS, MEIS, QNXT, PDM, MARx, Member360, AEVS to pre-screen prospective members for all lines of business.
Product Sales Regulatory Compliance:
Adheres to compliance of CMS, DHCS, and L.A. Care's Regulatory Affairs & Compliance regulatory guidelines. Utilizes and adheres to approved scripts and contact guidelines when conducting outreach calls to potential enrollees and when acting as outward facing support for contracted General Agencies.
Monthly and Quarterly Product Sales Performance Goals:
Consistently meets the minimum organizational and departmental enrollment benchmarks for product growth campaigns and meets minimum monthly and quarterly performance and production standards. Performance and production standards may be adjusted on a monthly, quarterly or annual basis as required to meet the department goals and objectives for all lines of business.
Perform other duties as assigned.Education Required High School Diploma/or High School Equivalency Certificate Education Preferred Experience
A minimum of 1 year of telesales experience.
Healthcare telesales experience. Direct sales or healthcare related experience, preferably in the Medi-Cal, Commercial, or Medicare.
Excellent interpersonal and client interaction skills with strong attention to detail and accuracy.
Must possess good writing skills and calm/professional telephone presence.
Ability to multi-task; flexible and comfortable working in a fast paced environment and committed to meeting deadlines.
Great attitude, energy and enthusiasm are critical.
Proficient skills in Microsoft Word, Excel, PowerPoint and Outlook.
Bilingual in one of L.A. Care Health Plan's threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese.
Ability to pass Medi-Cal Certification and Medicare Training Certification within 90 days of hire.
L.A. Care offers a wide range of benefits including
- Medical, Dental and Vision
- Wellness Program
- Paid Sick Leave
At L.A. Care, we value our team members' safety. In order to keep our work locations safe, each employee is required to self-screen for symptoms prior to entering any L.A. Care location each day. L.A. Care and all of its staff are required to comply with all state and local masking orders. Therefore, when on-site at any L.A. Care location, employees are expected to wear a mask in areas where physical distancing cannot be managed.
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