myPlace Health

Sales

• What Does Success Look Like As our Outreach Manager
• Shape Outreach & Marketing Strategy – Partner with leadership to develop strategies that drive growth and enhance brand awareness.
• Grow Our Enrollment Pipeline – Identify and cultivate new referral sources to bring more participants into our PACE program.
• Stay Ahead of the Market – Keep a pulse on competitors’ positioning to refine and enhance our outreach approach.
• Lead and Develop a High-Performing Team – Hire, train, mentor, and support outreach staff while ensuring they have the tools to succeed.
• Ensure Compliance & Best Practices – Oversee outreach and marketing activities to meet DHCS and CMS regulations.
• Build Meaningful Community Partnerships – Strengthen relationships with hospitals, providers, and community organizations to increase referrals.
• Enhance Outreach Processes – Evaluate and refine enrollment workflows to improve efficiency and participant experience.
• Leverage Data & Technology – Monitor and manage our CRM software to maintain accurate documentation and reporting.
• Collaborate for Success – Work closely with center leadership to meet enrollment goals and pass audits with confidence.
• Drive Enrollment & Marketing Execution – Implement marketing plans that deliver measurable results.
• Support Organizational Growth & Mission – Contribute to the organization’s overall success by working cross-functionally with teams, providing insights to improve outreach efforts, and ensuring that our enrollment strategies align with our mission of delivering high-quality care to seniors.

Healthcare Sales and Outreach Manager

Operations

• Champion Enrollment Success – Develop and manage seamless processes for participant Medicaid/Medi-Cal and Medicare enrollment, ensuring they maintain access to vital benefits.
• Keep Workflows on Track – Maintain accurate, real-time tracking for all eligibility and enrollment workflows across Medicare and Medi-Cal.
• Be a Pre-Enrollment Pro – Partner with LA County, IHSS, and Social Security to confirm all participant data is up-to-date, synced, and ready for enrollment.
• Own Part D Operations – Manage Part D enrollment and eligibility within Centers for Medicare & Medicaid Services systems (MARx, eRPT, COB, Transaction Facilitators), lead audits, and oversee retroactive eligibility processing.
• Drive Redetermination Efforts – Oversee California Department of Health Care Services (DHCS) redetermination data and collaborate with Social Workers to support timely renewals.
• Solve Complex Eligibility Issues – Lead troubleshooting for Part D plan operations including TROOP, PDE, and RAPS rejections.
• Deliver Personalized Support – Provide one-on-one assistance to PACE participants with warmth, care, and exceptional service.
• Guide Medicare Age-Ins – Support participants as they transition into Medicare, making the process smooth and stress-free.
• Track and Monitor with Precision – Oversee self-pay billing activities in partnership with Finance and TPA teams.
• Master the Data Game – Manage monthly enrollment reconciliations, capitation files, and vendor rosters to keep our systems aligned and accurate.
• Support Seamless Transitions – Assist enrollment and disenrollment teams with DHCS submissions, tracking, and compliance activities.
• Ensure Timely Authorizations – Monitor internal authorization workflows, ensure prompt prior authorizations, and conduct retro-reviews of unauthorized services.
• Be Audit-Ready Always – Document and support audit activities to maintain stellar health plan oversight.
• Oversee Participant Materials – Coordinate ID card requests and ensure ADA-compliant materials are delivered on time.
• Stay on Top of Regulations – Manage ongoing Part D regulatory reporting requirements with diligence and attention to detail.
• Wear Many Hats – Step in with all other duties as needed to help our mission thrive!

Healthcare Sales and Outreach Manager

Eligibility Coordinator – Health Plan Operations