Presbyterian Healthcare Services · 23 hours ago
Medicaid Outreach and Retention Representative
Albuquerque, NM
Full-time
Onsite
Mid Level
$45K/yr - $69K/yr
3+ years expPresbyterian Healthcare Services is a not-for-profit healthcare system dedicated to improving the health of patients and communities. They are hiring a Medicaid Outreach and Retention Representative responsible for statewide education, outreach, acquisition, and retention of Medicaid members while managing relationships with community agencies.
AssociationHealth Care
Responsibilities
Organizes, facilitates, and participates in community outreach and customer education events effectively communicating program attributes, plan benefits, services available, product changes, and regulatory requirements to a variety of audiences resulting in prospects successful application to the appropriate program
Secures supplies and marketing materials used in outreach and enrollment activities. Projects positive organizational image to the public. Prepares education materials to include handouts, workbooks, evaluation forms, and visual aids; reviews materials for compliance and quality
Educates members on a variety of governmental and commercial products; assists prospects and members with enrollment in Medicaid. Must be able to understand both business and member views in order to communicate necessary information so that it meets both business needs and member experience requirements
Researches, compiles, analyzes and interprets data to create reports and presents outcomes to management. Assist with special project work and project planning for statewide outreach opportunities. Tracks and reports outreach activity for reports required by the Health Care Authority, and NCQA
Attends and participates in departmental meetings as a means for receiving education and training on new policies, procedures and regulations
Networks, develops, and manages collaborative relationships with key contacts from external advocacy agencies; researches and responds to advocate requests regarding complex situations. Supports internal departments with education, and support with escalated benefit or service inquiries; internal departments to include, but not limited to; Government Programs Administration, Sales, PCSC, Enrollment, Claims, Experience Design Program, Appeals and Grievance, Health Services, Provider Network Management
Plans and conducts service and business recovery initiatives; contacts members to increase participation and educational and special events
Qualification
Required
Bachelors degree preferred; Associates degree or 3 years experience in lieu of degree
Demonstrated abilities through education and/or work experience
Obtain New Mexico State Presumptive Eligibility/ Medicaid On-site Application Assistance [PE/MOSAA] certification required or obtained within 90 days of hire
2-3 years experience in managed care organization preferably in Medicaid Plans and other dual-eligible or long-term care market products and programs
And/or 3-5 years customer service experience in health insurance, healthcare retention, community outreach or marketing
Excellent public speaking and presentation skills; demonstrated ability to communicate effectively in person, by phone and in writing to people with different cultural and socio-economic backgrounds
Excellent PC skills; MS Office/Windows required; database experience preferred; experience with integrated data management systems
Ability to travel within the State of New Mexico based on assigned territory and departmental need
Must be able to lift 35 to 70 pounds, packing, loading, event set up and take down regularly; frequent travel and occasional overnight stays
Must have own vehicle, a valid NM drivers license and maintain a good driving record
Must provide own transportation and be able to travel
Preferred
Bilingual Spanish-speaking, reading and writing preferred
Speak and understand one or more of New Mexico Native American languages (Tribes, Nations, or Pueblos), if applicable
Additionally, healthcare claims processing, provider network, or other background in research and resolution of complex issues experience preferred
Benefits
Medical
Dental
Vision
Short-term and long-term disability
Group term life insurance
Other optional voluntary benefits
Wellness activities like wellness challenges, webinar, preventive screening and more
Company
Presbyterian Healthcare Services
Presbyterian Healthcare Services exists to improve the health of patients, members and the communities they serve.
10001+ employees
H1B Sponsorship
Presbyterian Healthcare Services has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (90)
2024 (86)
2023 (85)
2022 (93)
2021 (86)
2020 (76)
Funding
Current Stage
Late StageLeadership Team
Dale Maxwell
President and CEO
Ernest Sanchez
Chief Technology Officer
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