Medicare Field Sales & Community Agent / Req 1006937932

Hybrid: Applicants must be a California resident as of their first day of employment.

PRINCIPAL RESPONSIBILITIES:

The Medicare Field Sales & Community Agent is responsible for compliantly achieving established monthly, quarterly, and annual Medicare Advantage (D-SNP) new enrollment and retention goals. Consistently enrolling self-generated, Partner generated, and company generated Medicaid conversion and marketing leads is essential to this role's success. The agent must work in collaboration with their team members and other Alameda Alliance for Health (AAH) department personnel to develop and execute an effective growth and retention strategy. A key part of that strategy will require them to work effectively and leverage relationships with providers, community organizations, and other influencers. Their engagement will take the form of participation in or sponsorship of local community events, individual provider co-marketing programs, and targeted member outreach activities in conjunction with community partners.

Medicare Field Sales & Community Agent will report to the Manager, Medicare Sales and Retention. The incumbent will be assigned specific responsibilities as determined by their manager based on opportunities identified related to product offerings, geographic or other market segmentation criteria.

The agent will be expected to generate new enrollments and achieve established retention targets through consistent and thoughtful member and prospect engagement activities. The agent must consistently complete proven "best practice" based activities to develop and manage their territories and/or assignments and provide regular status reporting at predetermined intervals via the sales departments established activity and performance tracking system. The agent will be expected to comply with all CMS, DMHC, and DHCS guidelines and quickly report any potential issues to their manager or Chief Compliance Officer.

Principle responsibilities include:

• Expected to consistently meet or exceed established performance standards across the following key areas:

• Production: Achieve a minimum of 60 enrollments per month, which equates to an average of three (3) enrollments per working day, based on a standard 20-day work month. Monthly targets may be adjusted to account for holidays, approved time off, or business needs.

• Quality: Maintain a minimum 85% quality adherence score on a monthly basis as measured by internal quality review standards, including accuracy of application submissions and adherence to sales protocols.

• Regulatory Compliance: Demonstrating a minimum of 85% adherence to all applicable federal and state regulations including CMS Medicare Marketing Guidelines and California specific requirements per month. This includes accurate, ethical, and compliant representation of all Medicare products and services.

• Putting the member or prospective members needs first and assisting them in their efforts to enroll with AAH via whatever channel best meets their needs, i.e. face-to-face, online, group setting, telephonic.

• Responsible for professionally representing AAH Medicare D-SNP programs in the market to all members, prospects, providers, and partners.

• Assisting prospective members in their efforts to understand AAH's products, services, mission, and unique value proposition.

• Work with internal staff, providers and community partners to create or participate in programs to engage, educate, and enroll existing AAH Dual Eligible Medi-Cal members.

• Provide staffing and support for member retention activities organized by the sales department or any of the Alliance's other departments.

• Consistently evaluate their activities in relationship to established sales and marketing CMS and compliance guidelines.

• Program requirements, including validation of data and internal controls.

• Provide market-level feedback to their sales and marketing leaders related to the competitive landscape.

• Understand how to use all core sales systems, i.e. lead and sales funnel management, weekly reporting, expense management, etc.

• Work collaboratively and respectfully with all team members, company staff, partners, and providers.

• Expected to practice good time and territory management behaviors to ensure maximum performance.

• Maturity to work independently.

• Ability to work effectively and efficiently in a deadline-driven environment.

• Adheres to all company policies and procedures relative to employment and job responsibilities.

• Other duties as assigned.

ESSENTIAL FUNCTIONS OF THE JOB:

• Contacts: Manage the enrollment application process for all new members as established by Sales Leadership, CMS, and the Compliance Department. Work closely with Broker Agencies to recruit, train, and motivate them to enroll members, if applicable.
• Conflict resolution: When member or prospect issues arise, respectfully capture the available information and quickly relay it to appropriate AAH department and personnel.
• Member Communications: Provide feedback and collaborate with the appropriate department related to current materials or share insights or information on any changes that could improve the member's experience.
• Computer: Utilize the existing systems provided by the organization to capture, track and report on all activities or information needed to ensure we continue to improve the experience of AAH members, partners, providers, and the community.
• Comply with the organization's Code of Conduct, all regulatory and contractual requirements, organizational policies, procedures, and internal controls.
• Assumes responsibility and exercises good judgement in making decisions within the scope of authority of the position.
• Be proficient in understanding Centers for Medicare and Medicaid Services (CMS) and DHCS/DMHC guidelines, as it relates to sales activities.
• Provides support to the Project Management Office (PMO) and various enterprise-wide activities based on availability.
• Organizes and facilitates sales project-related meetings, as necessary.
• Works effectively independently as well as part of a team and supports team decisions.
• Adapts to changes in requirements/priorities for daily and specialized tasks.
• Produces accurate and precise work, detects discrepancies, and resolves discrepancies all while meeting deadlines.

PHYSICAL REQUIREMENTS:

• Constant and close visual work at a desk or a computer.
• Constant sitting and working at a desk.
• Constant data entry using a keyboard and/or mouse.
• Frequent use of a telephone headset.
• Constant verbal and written communication with staff and other business associates by telephone, correspondence, or in person.
• Frequent lifting of folders and other objects weighing between 0 and 30 lbs.
• Frequent walking and standing.
• Frequent driving of automobiles to provider offices.

Number of Employees Directly Supervised: 0

Number of Employees Indirectly Supervised: 0

MINIMUM QUALIFICATIONS:

EDUCATION OR TRAINING EQUIVALENT TO:

• High school graduate or equivalent (GED)
• Bachelor's degree preferred or equivalent experience.
• 2026/2027 AHIP Certification required.
• Vaccination against seasonal influenza and COVID 19.
• Have a cleared TB test prior to or within seven days of hire.
• Evidence of immunity to Tdap, Hepatitis B, MMR, and Varicella.

MINIMUM YEARS OF ADDITIONAL RELATED EXPERIENCE:

• Two (2) to four (4) years' related work experience in a Medicare Advantage (MA) Plan or Medicare Advantage Dual Eligible Special Needs Plans (MA-DSNP) required.
• Required two (2) years Medicare Sales experience or in lieu, two (2) years selling or supporting seniors, including general understanding or Medicare and related products in either a face-to-face or telephonic setting required.

SPECIAL QUALIFICATIONS (SKILLS, ABILITIES, LICENSE):

• Other requirements as determined by clinic/facility if applicable.
• Must live in or within reasonable driving distance to Alameda County, California.
• Estimation of 60% salary base and 40% commission base based on tiered structure and business needs.
• Approximately 80% of time is spent in a provider's conference room / office.
• Willingness to occasionally work irregular hours based on business needs.
• Strong computer skills including proficiency in word processing, spreadsheet, and CRM database software skills required.
• Good understanding of agency distribution channel management.
• Basic knowledge of industry regulatory guidelines related to job functionality.
• Ability to work independently.
• Exceptional communication and interpersonal skills.
• Excellent organizational skills and capability to handle multiple campaigns at one time.
• Strong organizational skills with the ability to effectively prioritize multiple tasks and meet deadlines.
• Good territory and funnel management skills.
• Ability to maintain confidentiality related to sensitive matters.
• Strong ethical foundation and trustworthy character.
• The incumbent must have own vehicle and a valid driver's license with proof of insurance in conformity with state law minimums.
• California Health and Accident or Life, Health and Accident License.

Employees who interact with members of the public may be required to be tested for Tuberculosis and fully vaccinated against COVID-19 and influenza. Successful candidates for those positions/ classifications may be required to submit proof of vaccination against influenza and/or COVID-19, a negative Tuberculosis test, or request an exemption for qualifying medical or religious reasons during the onboarding process. Candidates should not present proof of vaccination until instructed to do so by the Human Resources department.

SALARY RANGE: $83,241.60 - $124,862.40 Annually

The Alliance is an equal opportunity employer and makes employment decisions on the basis of qualifications and merit. We strive to have the best qualified person in every job. Our policy prohibits unlawful discrimination based on race, color, creed, gender, religion, veteran status, marital status, registered domestic partner status, age, national origin or ancestry, physical or mental disability, medical condition, genetic characteristic, sexual orientation, gender identity or expression, or any other consideration made unlawful by federal, state, or local laws. M/F/Vets/Disabled.