Broker Services Specialist II

Job Summary

The Broker Services Specialist II supports the day to day broker channel service and growth strategy by providing support to L.A. Care’s general agencies and brokers.

This Broker Services Specialist is responsible for building and maintaining a positive and professional relationship with L.A. Care’s contracted General Agencies (GA) and their contracted Agents.

This position will provide training and basic knowledge on L.A. Care and specified lines of business, and be an expert in knowledge on Sales Force and all proprietary systems, procedures and tools.

This position is also responsible for performing support activities as needed to ensure that the GA and Agent experience with L.A. Care has a high degree of satisfaction.

In addition, a high degree of customer service is expected to all Management, the Sales Teams and interdepartmentally, to ensure that growth and retention for L.A. Care members and beneficiaries.

Duties

Customer Relations: (60%) Manage the inside support requirements of multiple inquiries from the contracted broker community. Outcomes Expected: Maintain relationships by answering inquiries from brokers, via Sales Force, telephonic, or any alternate communication. Follow through with timely responses, including research and resolution, as established by department Key Performance Indicator's (KPI).

Sales Operations/ Compliance and Regulatory Requirements: (25%) Serve as a liaison to Sales Operations and assist with; general agency contracting and agent onboarding, off boarding, transfer request processing for Cal MediConnect (CMC), LA Care Covered (LACC) and other product lines added. Assist with processing of new agent requests, agent inquiries inbox, management of license expirations, generate of appointment agent report for Finance, generate/validate compliance reports for Brokers, Office of Inspector General (OIG) report, agent termination report (LACC), America's Health Insurance Plans (AHIP) tracking and update. Work with internal Sales compliance staff to monitor sales regulations and adherence to State and Federal Marketing guidelines. In addition, work with systems to ensure appropriate data is collected for auditing purposes.

Represent L.A. Care with Broker and Strategic Partners: (5%) Participate in any L.A. Care related functions in support of growth for broker and partners. Outcomes Expected: Maintain relationships with partners by partaking in internal or external event requests. Represent L. A. Care in a professional manner. Collaborate interdepartmentally as needed and bring any pertinent information for presentation.

Monitor and Track Caseload: (5%) Monitor and track the progress and outcomes of partnerships through documentation and communication to management. Outcomes Expected: Review frequent reports to ensure inquiries are closed out according to Key Performance Indicator (KPI’s). Maintain Customer Relationship Management (CRM) tracking of general agency and agent profiles and other key information. Ensure documentation meets standards through regular audits. Maintain communication with management regarding trends of inquiries through daily tracking. Review all submitted problem and improvement reports; identify priority issues; evaluates opportunities for improvement, presents findings to supervisors for evaluation and prepares resolution work plan as directed. Develop and execute test plans. Monitor all solutions through to resolution.

Perform other duties as assigned. (5%)

Duties Continued

Education Required

High School Diploma/or High School Equivalency Certificate

Education Preferred

Associate's Degree

Experience

Required:
At least 0-2 years of working in a health plan or broker related environment, including but not limited to the following interface of these functions: Sales outreach and enrollment, Customer service; Project coordination; working knowledge and understanding of production regulations, including Medicare, Medi-Cal and Covered California

Preferred:
Experience with assisting beneficiaries in Covered California and Medicare.

Skills

Required:
Proven ability to significantly impact process improvement and process management.

Ability to document scope, project tasks in a clear and concise manner.

Thorough understanding of relevant industry practices, techniques and standards.

Must have a comprehensive understanding of business process/ life cycle management principles, theories and concepts.

Strong problem-solving/ analysis skills.

Proficiency in Microsoft Office applications, database management.

Ability to articulate relevant information and directions in an organized and concise manner.

Strong interpersonal, verbal, and written communication skills; Understanding of effective communication concepts tools and techniques.

Ability to conform to shifting priorities, demands, and timelines through analytical and problem-solving capabilities.

Persuasion Skills: Represent Manager in meetings. Demonstrate leadership and interpersonal communication skills by working collaboratively and effectively with peers, superiors and subordinates to accomplish objectives. Able to concisely, clearly and formally communicate complex concepts and formulate process solutions.

Preferred:
Knowledge of CRM systems and navigation for contact resolution

Licenses/Certifications Required

Medi-Cal and Medicare Training Certification (Or must be obtained within 90 days from date of hire.)

Licenses/Certifications Preferred

Required Training

Required:
Product trainings - MediCal, L.A. Care Covered, Medicare, Cal MediConnect

Physical Requirements

Light

Additional Information