Job Description

Your Role

The Blue Shield of California Promise Health Plan Growth & Retention team is looking for an Enrollment and Retention Specialist who will educate and assist callers with the Medi-Cal enrollment process as it pertains Medi-Cal eligibility and plan enrollment to achieve new enrollment and member retention goals. In this role you will also assist members with the annual Medi-Cal redetermination process, advocate for callers with internal departments as well as County and State agencies and supports other growth projects. Adherence to all compliance requirements and maintaining appropriate documentation is essential to this role. The Blue Shield Promise Growth & Retention team reports to the Growth & Retention Supervisor.

Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow – personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building and sustaining high-performing teams, getting results the right way, and fostering continuous learning.

Your Work

In this role, you will:

• ​​Handle independently day-to-day growth and retention calls meeting all department performance standards
• Provide comprehensive eligibility and enrollment information to callers to identify best BSC product
• Work independently to facilitate member enrollment by working with Federal, State and Local County agencies escalating complex cases as needed
• Work with existing BSC members to help them stay in any BSC product
• Take the initiative to help callers with cases by conducting thorough follow-up assistance and utilizing and managing tracking systems
• Enter timely and precise documentation in all required systems adhering to department guidelines to ensure accurate reporting
• Interact with members via telephone to educate and conduct various call campaigns
• May assist with testing new processes/procedures and system enhancements

Your Knowledge and Experience

• ​​Requires a High School Diploma or GED or 1 year of additional relevant experience in lieu of a diploma
• Requires at least 3 years of prior relevant experience
• Requires strong knowledge of the Medi-Cal program and Managed Care products/services
• Requires being Bilingual in Spanish
• Requires maintaining active compliance certifications

Hybrid Virtual Work

This role allows employees to work virtually full-time, however employees will be expected to come to the office based on business need.