Enrollment Specialist (Bilingual English/Spanish) - Remote

Job Description:

Enrollment Specialist (Bilingual English/Spanish) - Remote

Location

US-CA-Rancho Cucamonga

ID

2025-5347

Overview

What you can expect! 

Find joy in serving others with IEHP! We welcome you to join us in “healing and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!

Under the direction of the Enrollment Assistance Manager, the Enrollment Specialist is responsible for providing full-service application assistance to the uninsured, including screen for program eligibility, complete a Covered California or Medi-Cal application, and submit the application to Covered California or Medi-Cal Office on behalf the applicant. The Enrollment Specialist will follow-up on the submission to ensure the application is processed and a final decision is made on applicant's eligibility. The Enrollment Specialist will also outreach to auto-enrolled Covered California Members to help effectuate their membership.  For newly enrolled Medi-Cal beneficiaries who want to enroll with IEHP, the Specialist will assist to complete a Health Plan Choice Form to be submitted for State approval. Additional responsibilities include inbound and outbound sales calls and follow-up calls to help potential Members apply for Covered California and/or Medi-Cal. The Enrollment Specialist will also support external off-site enrollment events upon request.

This is a Bilingual (English/Spanish) position. The Team Member in this role must take a language proficiency assessment and must receive a passing score.

Commitment to Quality: The IEHP Team is committed to incorporate IEHP’s Quality Program goals including, but not limited to, HEDIS, CAHPS, and NCQA Accreditation.

Additional Benefits

Perks

IEHP is not only committed to healing and inspiring the human spirit of our Members, but we also aim to match our team members with the same energy by providing prime benefits and more.

• Competitive salary
• CalPERS retirement
• State of the art fitness center on-site
• Medical Insurance with Dental and Vision
• Life, short-term, and long-term disability options
• Career advancement opportunities and professional development
• Wellness programs that promote a healthy work-life balance
• Flexible Spending Account – Health Care/Childcare
• CalPERS retirement
• 457(b) option with a contribution match
• Paid life insurance for employees
• Pet care insurance

Key Responsibilities

1. Strive to live and practice IEHP’s Mission, Vision and Values (MVV) every day, and strongly commit to advance the organization’s strategic plan. 
2. Consistently meet or exceed daily, weekly, and monthly quotas for providing screening and/or application assistance, for inbound and outbound calls.
3. Provide excellent customer service during telephone screening and/or application assistance for Covered California, Medi-Cal, and other state health programs including conducting outbound sales campaigns to Members and the public.
4. As appropriate, complete applicable application form, while the customer is on the phone, then provide instruction for all related follow-up procedures and processes.
5. Provide in person assistance and/or application completion to any potential Member who walks in and requests enrollment assistance, application completion and/or information.
6. Qualify candidates by calculating their household income and by using other approved qualification methods and worksheets.
7. Advise candidates of the documentation required to complete the application and answer questions and issues about the enrollment process.
8. Provide Member guidance of key health plan benefits related to a Covered California and Medi-Cal plan
9. Outreach to auto-enrolled Covered California Members to help effectuate membership.
10. Complete all assigned reports or documentation to facilitate the successful enrollment into a designated program to include qualification worksheets, applications, appropriate letters, instructions to potential candidates and daily/weekly activity reports.
11. Communicate with Members utilizing translation applications/programs via applicable devices when candidates speak other languages and/or have a disability.
12. Assist in the development and training of new Enrollment Specialists, as needed.
13. Participate in planning discussions and meetings.  Assist in providing input in quality improvement processes and tactical plans to support outreach, enrollment, and retention goals.
14. Respond to all incoming and outgoing mail and complete other administrative unit duties assigned.
15. Document all calls in detail to create a recorded history for future interaction with each Member with Customer Relationship management (CRM) database. Present cases and work with a manager in resolving potential Member issues.

Qualifications

Education & Requirements 

• Three (3) years of experience in the following disciplines:

• • In-house sales
  • Outbound Sales Experience
  • High-volume telemarketing
  • High-volume consumer products/industrial distribution order taking
  • Customer Service in a high-call-volume environment
  • Outreach, Enrollment and Retention
• High School diploma or GED required
• Certification/License from Covered California (California's Health Exchange) to conduct Covered California and Medi-Cal Application is required
  • If not possessing a Certification at the time of hire, the candidate is required to obtain this Certification within six (6) months after been hired
  • This Certification needs to be renewed annually through an annual certification process conducted by Covered California
• This is a bilingual position. Identified bilingual team members in this role must take a language proficiency assessment and must receive a passing score.

Key Qualifications

• Valid California Driver's License Preferred
• Knowledge of the following areas:
• Medi-Cal and/or Covered California eligibility
• Customer service and phone etiquette
• Expert knowledge in the following areas:
• State Health Programs and the application and enrollment process
• Both Open and Special Enrollment Period eligibility requirements
• Skilled in data entry
• Will work a normal (8 a.m. - 5 p.m. or 9 a.m. - 6 p.m.) workday with some weekends, but work schedules and hours may vary depending upon department needs and Renewal/Enrollment Periods
• The Enrollment Specialist will be provided at least one week’s notice when a managerial change of a work schedule and/or hours is required

Start your journey towards a thriving future with IEHP and apply TODAY!

Work Model Location

Telecommute (All IEHP positions approved for telecommute or hybrid work locations may periodically be required to report to IEHP’s main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership)

Pay Range

USD $23.98 - USD $30.57 /Hr.