The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
We are currently hiring a Medicare Sales Agent to join our team! Offering a competitive bonus structure! Spanish speaking is required.
At this time, The Health Plan does not sponsor visa. Candidates must have legal and valid work authorization, Green Card or U.S. citizenship.
Must reside in California in our service area.
What You Will Be Doing:
Under general supervision, the Medicare Sales Agent is responsible for promoting and selling the Health Plan Medicare Advantage products with a focus on the Dual-Eligible Special Needs Plan (D-SNP) market. This role involves educating prospective members about Medicare and Medi-Cal programs, ensuring compliance with Centers for Medicare and Medicaid Services (CMS) and California Department of Health Care Services (DHCS) regulations, and driving enrollment growth within the San Joaquin, Stanislaus, Alpine and El Dorado County communities. Work is varied and moderately complex and requires a moderate degree of discretion and independent judgment. This will be a commission-based role.
Our Vision:
Continuously improve the health of our community.
Our Mission:
We provide healthcare value and advance wellness through community partnerships.
Essential Functions:
Develop and execute a strategic sales plan to drive Medicare enrollments, with a strong emphasis on the D-SNP population.Conduct one-on-one and group sales presentations to Medicare-eligible individuals, caregivers, and community organizations.Build and maintain strong relationships with community partners, providers, and key stakeholders to identify and support eligible individuals.Educate prospects on Medicare and Medi-Cal eligibility, benefits, and plan options while ensuring compliance with CMS and DHCS regulations.Attend and host community outreach events, health fairs, and informational sessions to generate leads and increase awareness.Maintain accurate records of sales activities, leads, and enrollments in compliance with regulatory guidelines.Provide exceptional customer service and follow-up to ensure high member satisfaction and retention.
What You Bring:
Knowledge, Skills, Abilities and Competencies
Required
Knowledge of Medi-Cal and MedicareFamiliarity with CMS and DHCS compliance regulations regarding Medi-Cal and Medicare sales and marketing requirements.Must convey outstanding listening and interpersonal skills and have the ability to effectively prioritize and execute tasks in a high-pressure environment and support strong customer service orientation.Must exhibit mastery experience in a team-oriented, collaborative environment as a self-starter with ability to work effectively with minimal direct supervision.Interpersonal skills - interacts effectively with individuals both inside and outside of HPSJ; relates openly and comfortably with diverse groups of people. Strong oral and written communication skills, with the ability to effectively communicate complex technical issues in terms clearly understood by technical and non- technical audiences and write technical specifications.Exemplifies excellent organizational, written, and verbal communication skills and the ability to interact professionally with a diverse group, executives, managers, and subject matter experts.Excellent communication, presentation, and interpersonal skills.Strong listening skills, with the ability to accurately receive and understand messages.Strong problem solving and analytical skills, with ability to determine key issues, develop effective action plans and implement successful conclusions.Produces work that is accurate and complete.Actively learns through experimentation when tackling new problems, using both successes and failures to learn.Rebounds from setbacks and adversity when facing difficult situations.Knows the most effective and efficient process to get things done, with a focus on continuous improvement. Strong skills in Windows, Excel, Word, Outlook, and CRM systems for tracking leads and enrollments.Ability to work independently and as part of a team.Ability to speak and be understood in English.Ability to handle confidential information with appropriate discretion.Ability to write and speak Spanish - will be tested.What You Have:
Education and Experience
Required
Bachelor’s degree or equivalent work experience required; withAt least 2 years’ experience with Medicare; and At least 2 years' experience in consulting or sales. Strong understanding of Medicare, Medi-Cal, CMS, and DHCS regulations.Preferred
Bachelors in business, healthcare, or sociology.Experience working in the Medi-Cal space.Medicare sales experience. Established community relationships with organizations serving Medicare and Medi-Cal populations.Experience conducting educational seminars and outreach events.Strong knowledge of low-income senior and disabled populations and their healthcare needs.Licenses, Certifications
Required
Active Life and Health Agent License is required within 90 days of hire.Achieve and maintain required training (including annual AHIP certification).Valid California driver license and reliable transportation or, the ability to obtain transportation on demand in the counties served by the Health Plan if prohibited from getting a driver license due to a medically documented disability. Reliable transportation and the ability to travel within assigned territories for events and appointments.
What You Will Get:
HPSJ Perks:
Competitive salaryRobust and affordable health/dental/vision with choices in providersGenerous paid time off (accrue up to 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays)CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution planTwo flexible spending accounts (FSAs)Employer-Paid Term Life and AD&D InsuranceEmployer-Paid Disability InsuranceEmployer-Paid Life Assistance ProgramHealth AdvocacySupplemental medical, legal, identity theft protectionAccess to exclusive discount mallEducation and training reimbursement in addition to employer-paid elective learning courses.A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.A shorter commute – if you’re commuting from the Central Valley to the Bay Area.Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects.
We are an equal opportunity employer and diversity is one of our core values. We believe that differences including race, ethnicity, gender, sexual orientation, and other characteristics, will help us create a strong organization that is sensitive to the needs of those we serve. Employment decisions are made on the basis of qualifications and merit.
HPSJ provides equal employment opportunities to employees and applicants for employment and prohibits discrimination based on color, race, gender (including gender identity and gender expression), religion (including religious dress and grooming practices), marital status, registered domestic partner status, age, national origin (including language use) or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), sex (including pregnancy, childbirth, breastfeeding or related medical condition), genetic information, sexual orientation, military or veteran status, political affiliation or any other characteristic made unlawful by applicable Federal, State or local laws. It also prohibits unlawful discrimination based on the perception that anyone has these characteristics or is associated with anyone who has or is perceived to have these characteristics.
Important Notice: This job description is not a contract between HPSJ and the employee performing the job. The duties listed in the job description may be changed at the discretion of HPSJ, and HPSJ may request the employee to perform duties that are not listed on the job description.
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The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
The Health Plan of San Joaquin is now hiring an experienced, mission-driven leader to serve as our Chief Medical Officer!
Location: This is a remote position. Must reside in California within our service area to effectively support operational needs. Must be able to attend monthly onsite meetings, and other meetings as needed for business and community purposes.
At this time, The Health Plan does not sponsor visa. Candidates must have legal and valid work authorization, Green Card or U.S. citizenship.
What You Will Be Doing:
As our Chief Medical Officer, under administrative direction, you will be responsible for leading efforts that will provide innovative solutions that support more affordable healthcare, promote personal accountability for health and wellness, and offer superior service and partnerships to the constituents served by HPSJ!
Supervises
Medical DirectorsDirector of PharmacyExecutive Assistant
Our Vision:
Continuously improve the health of our community.
Our Mission:
We provide healthcare value and advance wellness through community partnerships.
Essential Functions:
Identifies, develops, plans and executes short, medium and long-range strategies that drive and support corporate objectives; ensures the development and implementation of associated business plans, tactics and policies. Develops and oversees the implementation of medical management policies.Ensures that medical decisions are rendered by qualified medical personnel and are not influenced by fiscal or administrative management considerations.In collaboration with the Chief Heath Services Officer, will ensure consistent application of medical criteria to utilization management decision making.Collaborates with the Chief Health Services Officer in the strategic planning, implementation and oversight of the Quality Improvement and Quality Management Programs. Ensures that medical care provided meets acceptable medical care standards.Ensures that medical protocols and rules of conduct for HPSJ medical personnel are followed.Manages medical utilization through application of recognized medical and pharmaceutical guidelines and in collaboration internal and external stakeholders.Oversees the development and management of department budgets.Oversees accreditation and compliance activities to ensure agreed upon and mandated standards are met. In collaboration with the Chief Heath Services Officer, will identify medical delivery system quality issues; develops and oversees implementation of corrective action plans.Collaborates with network providers and the provider community in a manner that engenders positive relationships, provider support and network stability.Advises on complex, controversial and/or unique claims that are outside the realm of medical policy.Co-Chairs the Quality Improvement and Health Equity Transformation Committee and Chairs the Peer Review and Credentialing committee; serve on other committees as required.Ensures that effective collaborative work and problem-solving routines are maintained between assigned departments, and other internal and external stakeholders.Oversees the identification, preparation and maintenance of appropriate and required data, records and reports.Represents HPSJ in a manner that promotes a positive image of HPSJ in the community; serves on internal and external committees and other leadership forums.Promotes and maintains and ensures that direct reports promote and maintain an environment that supports HPSJ’s strategy, vision, mission and values.Hires, develops and retains, and ensures that line managers hire, develop and retain, a competent staff.
What You Bring:
Knowledge, Skills, Abilities and Competencies
Required
Expert knowledge of the principles, practices and techniques of managed care, utilization management and quality.Knowledge of laws and regulations governing managed care.Expert knowledge of contemporary health issues, and the healthcare, economic or other issues affecting Medi-Cal and/or Medicare populations, providers and the underserved in San Joaquin and surrounding areas.Knowledge of quality improvement and utilization management procedures and techniques.Knowledge of the management and best practices techniques of a medical practice or office.Strategic mindset: Sees ahead to future possibilities and translates them into breakthrough strategies; identifies, plans, leads and executes meet changing organizational and community needs, and regulatory requirements.Cultivates innovation: Creates new and better ways for the organization to be successful.Drives results: Consistently achieves results, even under tough circumstances.Drives engagement: Creates a climate where people are motivated to do their best to help the organization achieve its objectives.Drives vision and purpose: Paints a compelling picture of the vision and strategy that motivates others to action.Courage: Steps up to address difficult issues, says what needs to be said.Nimble learning: Actively learns through experimentation when tackling new problems, uses both successes and failures as learning fodder.Situational adaptability: Adapts approach and demeanor in real time to match the shifting demands of different situations.Uses Lean, Performance Improvement, Return on Investment and metrics to successfully manage the division. Strong skills in budget development and management.Communicates effectively: Develops and delivers multi-mode communications that convey a clear understanding of the unique needs of different audiences.Strong presentation skills, including the ability to tailor presentations to a specific audience, and address and interact with large groups.Very strong interpersonal skills, with the ability to establish and maintain effective working relationships with individuals at all levels inside and outside of HPSJ.Strong assessment and analytical skills, including the ability to synthesize, distill concepts, draw conclusions and identify implications.Manages complexity: Makes sense of complex, high quantity, and sometimes contradictory information to effectively solve problems.Resourcefulness: Secures and deploys resources effectively and efficiently; organizes people and resources to solve problems and identify opportunities.Plans and aligns: Plans and prioritizes work for self and others to meet commitments aligned with organization goals.Very strong project management skills, with the ability to function as a sponsor and owner on complex projects; a track record of successful large project implementations. Very strong collaboration skills with demonstrated ability to create and foster a collaborative work environment, maintain effective, high-performance teams, and organize people and resources to solve problems and identify business opportunities. Strong customer service skills.Ensures accountability: Holds self and others accountable to meet commitments.Strong knowledge of change management theory, with ability to anticipate and implement effectively.Promotes and maintains and ensures that direct reports promote and maintain an environment that supports HPSJ’s strategy, vision, mission and values.Very strong coaching/counseling skills, including the ability to function as a mentor to management and employees by assisting in the identification and resolution of issues.Demonstrated ability to supervise staff in a manner that maximizes employee performance and business results.Ability to speak and be understood in English.Ability to handle confidential information with appropriate discretion.Preferred
Familiarity with seniors and Persons with Disabilities and Dual Eligible preferred. Familiarity with information technology, electronic medical records and other technological applications. Good knowledge of NCQA accreditation, HEDIS and have a contemporary knowledge of regulatory and governmental affairs.
What You Have:
Education and Experience
Required
MD degree from an accredited medical school.Satisfactory completion of an American Council of Graduate Medical Education accredited residency program; andAt least ten years clinical experience in the practice of medicine in fields related to a managed care setting; andAt least five years clinical experience in the practice of medicine with MediCal and/or Medicare populations; orEquivalent combination of education and experience.Licenses, Certifications
Required
Unrestricted, active license to practice medicine in the State of California, issued by the State Board of Medical Examiners, which meets the Health Plan’s credentialing and recredentialing requirements.Board Certification in a medical specialty; andSatisfactory completion of an American Council of Graduate Medical Education accredited residency program; andValid California driver license and reliable transportation or, the ability to obtain transportation on demand in the counties served by HPSJ if prohibited from getting a driver license due to a medically documented disability.
What You Will Get:
HPSJ Perks:
Competitive salaryRobust and affordable health/dental/vision with choices in providersGenerous paid time off (accrue up to 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays)CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution planTwo flexible spending accounts (FSAs)Employer-Paid Term Life and AD&D InsuranceEmployer-Paid Disability InsuranceEmployer-Paid Life Assistance ProgramHealth AdvocacySupplemental medical, legal, identity theft protectionAccess to exclusive discount mallEducation and training reimbursement in addition to employer-paid elective learning courses.A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.A shorter commute – if you’re commuting from the Central Valley to the Bay Area.Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects.
Physical Demands
Frequent sitting, standing and walking, constant repetitive motion, frequent talking and listening, occasional handling of materials up to 50 lbs., closeup and distance vision requirements, occasional travel.
We are an equal opportunity employer and diversity is one of our core values. We believe that differences including race, ethnicity, gender, sexual orientation, and other characteristics, will help us create a strong organization that is sensitive to the needs of those we serve. Employment decisions are made on the basis of qualifications and merit.
HPSJ provides equal employment opportunities to employees and applicants for employment and prohibits discrimination based on color, race, gender (including gender identity and gender expression), religion (including religious dress and grooming practices), marital status, registered domestic partner status, age, national origin (including language use) or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), sex (including pregnancy, childbirth, breastfeeding or related medical condition), genetic information, sexual orientation, military or veteran status, political affiliation or any other characteristic made unlawful by applicable Federal, State or local laws. It also prohibits unlawful discrimination based on the perception that anyone has these characteristics or is associated with anyone who has or is perceived to have these characteristics.
Important Notice: This job description is not a contract between HPSJ and the employee performing the job. The duties listed in the job description may be changed at the discretion of HPSJ, and HPSJ may request the employee to perform duties that are not listed on the job description.
Read LessThe expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.
The Health Plan of San Joaquin is now hiring an experienced, mission-driven leader to serve as our Chief Medical Officer!
Location: This is a remote position. Must reside in California within our service area to effectively support operational needs. Must be able to attend monthly onsite meetings, and other meetings as needed for business and community purposes.
At this time, The Health Plan does not sponsor visa. Candidates must have legal and valid work authorization, Green Card or U.S. citizenship.
What You Will Be Doing:
As our Chief Medical Officer, under administrative direction, you will be responsible for leading efforts that will provide innovative solutions that support more affordable healthcare, promote personal accountability for health and wellness, and offer superior service and partnerships to the constituents served by HPSJ!
Supervises
Medical DirectorsDirector of PharmacyExecutive Assistant
Our Vision:
Continuously improve the health of our community.
Our Mission:
We provide healthcare value and advance wellness through community partnerships.
Essential Functions:
Identifies, develops, plans and executes short, medium and long-range strategies that drive and support corporate objectives; ensures the development and implementation of associated business plans, tactics and policies. Develops and oversees the implementation of medical management policies.Ensures that medical decisions are rendered by qualified medical personnel and are not influenced by fiscal or administrative management considerations.In collaboration with the Chief Heath Services Officer, will ensure consistent application of medical criteria to utilization management decision making.Collaborates with the Chief Health Services Officer in the strategic planning, implementation and oversight of the Quality Improvement and Quality Management Programs. Ensures that medical care provided meets acceptable medical care standards.Ensures that medical protocols and rules of conduct for HPSJ medical personnel are followed.Manages medical utilization through application of recognized medical and pharmaceutical guidelines and in collaboration internal and external stakeholders.Oversees the development and management of department budgets.Oversees accreditation and compliance activities to ensure agreed upon and mandated standards are met. In collaboration with the Chief Heath Services Officer, will identify medical delivery system quality issues; develops and oversees implementation of corrective action plans.Collaborates with network providers and the provider community in a manner that engenders positive relationships, provider support and network stability.Advises on complex, controversial and/or unique claims that are outside the realm of medical policy.Co-Chairs the Quality Improvement and Health Equity Transformation Committee and Chairs the Peer Review and Credentialing committee; serve on other committees as required.Ensures that effective collaborative work and problem-solving routines are maintained between assigned departments, and other internal and external stakeholders.Oversees the identification, preparation and maintenance of appropriate and required data, records and reports.Represents HPSJ in a manner that promotes a positive image of HPSJ in the community; serves on internal and external committees and other leadership forums.Promotes and maintains and ensures that direct reports promote and maintain an environment that supports HPSJ’s strategy, vision, mission and values.Hires, develops and retains, and ensures that line managers hire, develop and retain, a competent staff.
What You Bring:
Knowledge, Skills, Abilities and Competencies
Required
Expert knowledge of the principles, practices and techniques of managed care, utilization management and quality.Knowledge of laws and regulations governing managed care.Expert knowledge of contemporary health issues, and the healthcare, economic or other issues affecting Medi-Cal and/or Medicare populations, providers and the underserved in San Joaquin and surrounding areas.Knowledge of quality improvement and utilization management procedures and techniques.Knowledge of the management and best practices techniques of a medical practice or office.Strategic mindset: Sees ahead to future possibilities and translates them into breakthrough strategies; identifies, plans, leads and executes meet changing organizational and community needs, and regulatory requirements.Cultivates innovation: Creates new and better ways for the organization to be successful.Drives results: Consistently achieves results, even under tough circumstances.Drives engagement: Creates a climate where people are motivated to do their best to help the organization achieve its objectives.Drives vision and purpose: Paints a compelling picture of the vision and strategy that motivates others to action.Courage: Steps up to address difficult issues, says what needs to be said.Nimble learning: Actively learns through experimentation when tackling new problems, uses both successes and failures as learning fodder.Situational adaptability: Adapts approach and demeanor in real time to match the shifting demands of different situations.Uses Lean, Performance Improvement, Return on Investment and metrics to successfully manage the division. Strong skills in budget development and management.Communicates effectively: Develops and delivers multi-mode communications that convey a clear understanding of the unique needs of different audiences.Strong presentation skills, including the ability to tailor presentations to a specific audience, and address and interact with large groups.Very strong interpersonal skills, with the ability to establish and maintain effective working relationships with individuals at all levels inside and outside of HPSJ.Strong assessment and analytical skills, including the ability to synthesize, distill concepts, draw conclusions and identify implications.Manages complexity: Makes sense of complex, high quantity, and sometimes contradictory information to effectively solve problems.Resourcefulness: Secures and deploys resources effectively and efficiently; organizes people and resources to solve problems and identify opportunities.Plans and aligns: Plans and prioritizes work for self and others to meet commitments aligned with organization goals.Very strong project management skills, with the ability to function as a sponsor and owner on complex projects; a track record of successful large project implementations. Very strong collaboration skills with demonstrated ability to create and foster a collaborative work environment, maintain effective, high-performance teams, and organize people and resources to solve problems and identify business opportunities. Strong customer service skills.Ensures accountability: Holds self and others accountable to meet commitments.Strong knowledge of change management theory, with ability to anticipate and implement effectively.Promotes and maintains and ensures that direct reports promote and maintain an environment that supports HPSJ’s strategy, vision, mission and values.Very strong coaching/counseling skills, including the ability to function as a mentor to management and employees by assisting in the identification and resolution of issues.Demonstrated ability to supervise staff in a manner that maximizes employee performance and business results.Ability to speak and be understood in English.Ability to handle confidential information with appropriate discretion.Preferred
Familiarity with seniors and Persons with Disabilities and Dual Eligible preferred. Familiarity with information technology, electronic medical records and other technological applications. Good knowledge of NCQA accreditation, HEDIS and have a contemporary knowledge of regulatory and governmental affairs.
What You Have:
Education and Experience
Required
MD degree from an accredited medical school.Satisfactory completion of an American Council of Graduate Medical Education accredited residency program; andAt least ten years clinical experience in the practice of medicine in fields related to a managed care setting; andAt least five years clinical experience in the practice of medicine with MediCal and/or Medicare populations; orEquivalent combination of education and experience.Licenses, Certifications
Required
Unrestricted, active license to practice medicine in the State of California, issued by the State Board of Medical Examiners, which meets the Health Plan’s credentialing and recredentialing requirements.Board Certification in a medical specialty; andSatisfactory completion of an American Council of Graduate Medical Education accredited residency program; andValid California driver license and reliable transportation or, the ability to obtain transportation on demand in the counties served by HPSJ if prohibited from getting a driver license due to a medically documented disability.
What You Will Get:
HPSJ Perks:
Competitive salaryRobust and affordable health/dental/vision with choices in providersGenerous paid time off (accrue up to 3 weeks of PTO, 4 paid floating holidays including employee’s birthday, and 9 paid holidays)CalPERS retirement pension program, automatic employer-paid retirements contributions, in addition to voluntary defined contribution planTwo flexible spending accounts (FSAs)Employer-Paid Term Life and AD&D InsuranceEmployer-Paid Disability InsuranceEmployer-Paid Life Assistance ProgramHealth AdvocacySupplemental medical, legal, identity theft protectionAccess to exclusive discount mallEducation and training reimbursement in addition to employer-paid elective learning courses.A chance to work for an organization that is mission-driven – our members and community are at the core of everything we do.A shorter commute – if you’re commuting from the Central Valley to the Bay Area.Visibility and variety – you have a chance to work with people at all levels of the organization, and work on diverse projects.
Physical Demands
Frequent sitting, standing and walking, constant repetitive motion, frequent talking and listening, occasional handling of materials up to 50 lbs., closeup and distance vision requirements, occasional travel.
We are an equal opportunity employer and diversity is one of our core values. We believe that differences including race, ethnicity, gender, sexual orientation, and other characteristics, will help us create a strong organization that is sensitive to the needs of those we serve. Employment decisions are made on the basis of qualifications and merit.
HPSJ provides equal employment opportunities to employees and applicants for employment and prohibits discrimination based on color, race, gender (including gender identity and gender expression), religion (including religious dress and grooming practices), marital status, registered domestic partner status, age, national origin (including language use) or ancestry, physical or mental disability, medical condition (including cancer and genetic characteristics), sex (including pregnancy, childbirth, breastfeeding or related medical condition), genetic information, sexual orientation, military or veteran status, political affiliation or any other characteristic made unlawful by applicable Federal, State or local laws. It also prohibits unlawful discrimination based on the perception that anyone has these characteristics or is associated with anyone who has or is perceived to have these characteristics.
Important Notice: This job description is not a contract between HPSJ and the employee performing the job. The duties listed in the job description may be changed at the discretion of HPSJ, and HPSJ may request the employee to perform duties that are not listed on the job description.
Read Less