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Health Plan Field Representative II

Job Category:  Sales & Marketing
Department:  Product Sales

Los Angeles, CA, US, 90017

Position Type:  Full Time
Requisition ID:  8565


Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

As a condition of employment, L.A. Care requires a COVID-19 vaccine. This requirement includes our remote workforce. If you would like to request an exemption, L.A. Care has implemented a process to consider exemptions, for documented medical conditions and sincerely held religious beliefs. L.A. Care will review all exemption requests prior to proceeding with the recruitment process.

Job Summary

The Health Plan Field Representative I maintains professional working knowledge of L.A. Care products: Cal MediConnect, Medi-Cal, LA Care Covered and LA Care Covered direct for the express purpose of growth and retention initiatives.  The role entails the implementation and coordination of outreach activities focused on increasing enrollment for L.A. Care direct lines of business such as community presentations on program eligibility and outreach events. The Level II role applies a more experienced and in-depth understanding of products and benefits in order to help perspective members make enrollment decisions. Level II representatives are expected to better understand internal enrollment processes, have advanced product experience and have a more comprehensive skill set associated with the education and enrollment processes associated with our products. This position will develop and cultivate relationships through a combination of direct and indirect marketing activities to reach the targeted eligible population. The position is required to maintain active relationships with plan providers (PCP's and Medical groups),  community based organizations, faith based organizations, senior centers and small businesses.  


Provider Marketing
Selling our CalMediconnect plan to Medicare beneficiaries residing in Los Angeles County. Responsible for  selling our Medicare product through working with our network of physicians, hospitals, medical groups and other strategic relationships.


Outreach Activities and Events
Coordinating and conducting community presentations on program eligibility, and participating in community networking meetings, senior health care activities, health fairs and outreach events. Identifying grassroots opportunities, networking and referral generation. Develops and cultivates internal and external relationships.


Telesales and In-Home Appointments
Representatives are required to also engage in telesales activities meant to support Provider and Outreach activities. Representatives will be asked to self-generate leads as well as work leads assigned to them by management with the express purpose of enrollment prospective members in our  plans. In addition representatives will also be asked to facilitate and coordinate in-home appointments for members requesting them.


Sales Data Management
Ensures the integrity of data. Effectively utilizes the Customer Relationship Management (CRM) system to manage the sales referral pipeline and lead algorithm assignments.  Enters Data accurately by following the Goldmine and QNXT guidelines. Responsible for maintaining the quality and integrity of the CRM database through constant training on upgrades on the CRM data database. Maintains a high proficiency of  the internal and external systems. Demonstrates efficient use of internal proprietary systems, including but not limited to: CISCO, QMEIS, MEIS, QNXT, PDM, Marx, Member360, AEVS to pre-screen prospective members for all lines of business.


Product Sales Regulatory Compliance:
Adheres to compliance of CMS, DHCS, and L.A. Care's Regulatory Affairs & Compliance regulatory guidelines.  Utilizes and adheres to approved scripts and contact guidelines when conducting outreach calls to potential enrollees and when acting as outward facing support for contracted General Agencies.


Monthly and Quarterly Product Sales Performance Goals:
Consistently meets the minimum organizational and departmental enrollment benchmarks for product growth campaigns and meets minimum monthly and quarterly performance and production standards for a Levee II representative. Performance and production standards may be adjusted on a monthly, quarterly or annual basis as required to meet the department goals and objectives for all lines of business.


Perform other duties as assigned.


Education Required

High School Diploma/or High School Equivalency Certificate

Education Preferred


Minimum of 2 years of field sales experience


Experience in sales of  Managed Care products including Medicare Advantage, Medi-Cal and Covered California.


Excellent interpersonal and client interaction skills with strong attention to detail and accuracy.


Ability to apply in-depth knowledge of product lines for positive outcomes for inbound call inquiries and outbound product education and enrollment activities.


Must possess excellent writing skills and calm/professional telephone presence.


Ability to multi-task; flexible and comfortable working in a fast paced environment and committed to meeting deadlines.


Great attitude, energy and enthusiasm are critical.


Proficient skills in Microsoft Word, Excel, PowerPoint and Outlook.


Bilingual in one of L.A. Care Health Plan’s threshold languages is highly desirable. English, Spanish, Chinese, Armenian, Arabic, Farsi, Khmer, Korean, Russian, Tagalog, Vietnamese.

Licenses/Certifications Required

Life & Health Insurance License - Active, current and unrestricted California License
America's Health Insurance Plan (AHIP) Medicare Designation
Covered CA Certification.

Licenses/Certifications Preferred

Required Training

Ability to pass Medi-Cal Certification, and Medicare training certification within 90 days of hire.

Additional Information

Travel to offsite locations for work.


L.A. Care offers a wide range of benefits including

  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program
  • Volunteer Time Off (VTO)


At L.A. Care, we value our team members’ safety. In order to keep our work locations safe, each employee is required to self-screen for symptoms prior to entering any L.A. Care location each day. L.A. Care and all of its staff are required to comply with all state and local masking orders. Therefore, when on-site at any L.A. Care location, employees are expected to wear a mask in areas where physical distancing cannot be managed.

Nearest Major Market: Los Angeles

Job Segment: Medicare, Relationship Manager, Medical, Healthcare, Customer Service

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