• Responsible for reviewing plan provisions and applying specific rules inherent to Individual or Group enrollment scenarios. • Apply contractual, state and federal guidelines as appropriate, ensuring work is in compliance with federal and state regulations. • Provide technical support to assigned teams/strategic implementation partners by researching and/or troubleshooting issues related to processing, system, and software applications. • Serve as a resource for customers by researching complex systems issues impacting member eligibility and determining appropriate course of action. • Escalate issues or concerns to ensure desired results. • Conduct performance audits to ensure transaction compliance, accuracy and timeliness. • Identifies, recommends and implements process improvements. • Represent department on cross-functional teams and meets with external customers as required. • Regularly reviews procedures and training material for in-team and strategic implementation partner training, through partnership with the training and quality coaching teams, to outline and implement improvements for increased efficiency. • Provide back-up and peak-load assistance across Enrollment & Billing as needed; complete special projects and perform other duties as assigned. • Track, monitor, update, and follow-up with strategic implementation partner on audit findings, action plans, and information requests to ensure each item on the action plan is completed in a timely and accurate manner. • Process plan changes, dependent add-ons, direct transfers, transfer accumulators and more challenging types of enrollments. • Update eligibility, enrollment and/or billing of accounts. • Contact customers or Producer agents for enrollment clarification and/or to provide administrative/regulatory guidelines. This may include creating written correspondence regarding complex billing and enrollment issues. • Must meet or exceed department production and quality standards and remain current on company/departmental policies and procedures. • Educate agents and members on general membership and billing processes and administrative rules; may include Web portal usage and contract or regulation interpretation. • Perform other duties as assigned.

• Engage with potential patients through outbound calls to promote and enroll them in our services. • Provide detailed information about our services, highlighting the benefits and features to prospective patients. • Address inquiries, concerns, and objections effectively to secure enrollments. • Guide patients through the enrollment process, ensuring all necessary information is collected accurately. • Maintain up-to-date knowledge of enrollment policies, procedures, and compliance requirements. • Maintain a patient-focused approach to enhance the overall enrolling experience. • Collaborate with team members to share best practices and strategies for achieving enrollment/metric goals. • Communicate effectively with other departments to ensure seamless service delivery and customer satisfaction. • Participate in training sessions and team meetings to stay informed about services and industry trends. • Achieve and exceed monthly enrollment targets and performance metrics. • Track and report enrollment activities, outcomes, and performance to supervisors. • Utilize CRM (Salesforce) software to document patient interactions. • Adhere to all company policies, procedures, and ethical standards. • Ensure compliance with regulatory requirements and company guidelines during the sales and enrollment process. • Maintain accurate and secure records of customer interactions and transactions.

• Conduct high-volume inbound and outbound patient outreach through phone to educate, engage, support, and enroll eligible patients. • Explain the purpose, benefits, and value of care management programs in a clear, accurate, and patient-friendly manner. • Build rapport with patients while professionally addressing questions, concerns, and enrollment objections to encourage participation. • Manage the Scheduling inbox by responding to patient inquiries, triaging requests, routing clinical concerns, and ensuring timely follow-up in accordance with established workflows. • Accurately document patient interactions, outreach attempts, enrollment outcomes, and other required information in a timely manner. • Collaborate with client care teams, providers, and internal partners to ensure a seamless patient experience and continuity of care. • Follow established outreach workflows, scripts, quality standards, and compliance requirements while adapting conversations to meet individual patient needs. • Identify and escalate patient concerns, engagement barriers, and operational issues while effectively managing competing priorities and contributing to process improvements that support enrollment success.

• Serve as the first point of contact that will introduce patients to the program and help them enroll via a smartphone app • Conduct outbound calls (to program-eligible patients) and successfully convert those calls into enrollments • Create exceptional patient enrollment experiences and share insights with your peers • Evangelize the program benefits and the impact it will have on member health • Deliver value to our partners and strengthen relationships through feedback, communication, and collaboration • Gather patient insights on enrollment experience in order to outline areas of growth and opportunity • Maximize team growth by delivering observations and identifying trends to help the team as it grows