Medicare Sales Oversight Specialist
New Orleans, LA 
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Posted 5 days ago
Job Description

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, andinnovate.Webelieve that every award earned, every record broken and every patient helped is because of the dedicated employees who fill our hallways.

At Ochsner, whether you work with patients every day or support those who do, you are making a difference and that matters. Come make a difference at Ochsner Health and discover your future today!

The Medicare Sales Oversight Specialist supports the Sales and Marketing department and will oversee the Agent Broker Oversight program. This role is responsible for inspecting both internal and external agent/broker sales transactions to identify inefficiencies and ensure performance and adherence to with federal and state laws, CMS regulations, and other regulatory requirements, helping to drive best-in-class processes, service and ensure an effective agent/broker oversight program.

Job Description

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essential duties.

This job description is a summary of the primary duties and responsibilities of the job and position. It is not intended to be a comprehensive or all-inclusive listing of duties and responsibilities. Contents are subject to change at the company's discretion.

Education

Required - bachelor's degree in business, Marketing, Sales, or any related field of study.

Work Experience

Required - 5 or more years with Medicare Advantage oversight and monitoring experience or similar responsibilities in a related field. 3 additional years of experience accepted in lieu of educational requirements.

Knowledge Skills and Abilities (KSAs)

  • Proficiency in using computers, software, and web-based applications.
  • Excellent verbal and written communication skills and ability to present information clearly and professionally.
  • Knowledge of Medicare Advantage health plans and sales oversight requirements
  • Ability to analyze complex sales documents and activities, problem solve, and compile reports.
  • Ability to work independently under minimal supervision and in a home office setting.
  • Ability to travel occasionally but no greater than 25% of the time.

Job Duties

  • Performs assigned sales monitoring activities accurately and timely.
  • Performs analysis of sales activities to identify potential or existing issues and collaborates with internal departments including Compliance regarding findings and trends to identify root causes.
  • Identifies opportunities for changes and/or improvements to activities and provides feedback to the Sales leadership and recommends process improvements.
  • Develops and maintains a dashboard outlining the progress and status of reviews conducted.
  • Prepares various reports for Delegation Oversight committee, Compliance Officer and delegated entities. Reports include corrective action plans when deficiencies are identified, and documents follow-up to completion.
  • Ensures compliance with reporting requirements by tracking the receipt and completeness of reports and presents to the Delegation Oversight Committee.
  • Provides training and coaching on compliance requirements including but not limited to: contact rules, compliant and thorough sales presentations, avoiding member complaints, sales and educational events, identification of proper enrollment periods, privacy/security, compliant enrollment methods, etc.
  • Monitors activities of the Medicare Sales Representative team as outlined in oversight and monitoring activities checklist to ensure compliance with CMS and any other health plan regulations.
  • Creates and provides OHP agents CMS compliant health plan marketing materials including resources to aid OHP agents during sales presentations.
  • Performs other related duties as assigned.

The above statements describe the general nature and level of work only. They are not an exhaustive list of all required responsibilities, duties, and skills. Other duties may be added, or this description amended at any time.

Remains knowledgeable on current federal, state and local laws, accreditation standards or regulatory agency requirements that apply to the assigned area of responsibility and ensures compliance with all such laws, regulations and standards.

This employer maintains and complies with its Compliance & Privacy Program and Standards of Conduct, including the immediate reporting of any known or suspected unethical or questionable behaviors or conduct; patient/employee safety, patient privacy, and/or other compliance-related concerns. The employer is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, or disability status.

Physical and Environmental Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Normal routine involves no exposure to blood, body fluid or tissue and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid.

The incumbent has no occupational risk for exposure to communicable diseases.

Because the incumbent works within a healthcare setting, there may be occupational risk for exposure to hazardous medications or hazardous waste within the environment through receipt, transport, storage, preparation, dispensing, administration, cleaning and/or disposal of contaminated waste. The risk level of exposure may increase depending on the essential job duties of the role.

Are you ready to make a difference? Apply Today!

Ochsner Health does not consider an individual an applicant until they have formally applied to the open position on this careers website.

Individuals who reside in and will work from the following areas are not eligible for remote work position: Colorado, California, Washington, New York, and Washington D.C.

Ochsner Health endeavors to make our site accessible to all users. If you would like to contact us regarding the accessibility of our website, or if you need an accommodation to complete the application process, please contact our HR Employee Solution Center at 504-842-4748 (select option 1) orcareers@ochsner.org. This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.

We are proud to be an Equal Employment Opportunity and Affirmative Action employer. We are committed to the principles of equal employment opportunity and providing a workplace that is free from discrimination based on race, color, creed, religion, pregnancy status, pregnancy-related conditions, national origin, ancestry, mental or physical disability, medical condition, age, veteran status, military status, citizenship status, marital status, familial status, sexual orientation, gender, gender identity or expression, genetic information, political affiliation, unemployment status, or any other characteristic protected under applicable federal, state or local law. These protections extend to applicants and all employment related decisions. View theEEO is the Law posterand itssupplement, as well as thepay transparency policyfor more information.

Affirmative Action Policy Statement


Ochsner is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, disability status, protected veteran status, or any other characteristic protected by law.

 

Job Summary
Start Date
As soon as possible
Employment Term and Type
Regular, Full Time
Required Education
Bachelor's Degree
Required Experience
5+ years
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