Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.
What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.
Under the direction of the Director of Member Experience (MX), the Member Experience (MX) Specialist I is responsible for deploying member experience strategies by collecting and tracking member feedback from all delivery channels in the organization. The MX Specialist will help identify patterns of member problems that occur most often working with other business units to help prevent reoccurrence in the future and improve the member experience.
The Member Experience Specialist I job description is intended to point out major responsibilities within the role, but it is not limited to these items.
- Conducting telephonic outreach for New Member Onboarding, CAHPS, HEDIS, Stars, and Voluntary Disenrollment Campaigns
- Engage members through a focused, meaningful, educational approaches to proactively address member abrasion points
- Providing education of the plan's Model of Care and triage to Care Management Programs
- Assistance in accessing and navigating member material resources (Member App, EOC, Formularies, Directories)
- Providing information on membership fees, policies, processes, benefits, products, and services.
- Driving members to take an active role with the Plan's network, supplemental vendors, health & wellness programs, and various health-centered incentives
- Identifying opportunities for improvement in member experience
- Support process improvement in collaboration with management efforts
- Partnering with leadership to bridge gaps between interdepartmental hand-off and follow-ups in accordance with established Service Level Agreements (SLAs).
- As needed work with members to address their concerns and in turn refer unresolved member issues or special requests to designated departments for further investigation.
Education & Training Requirements
- Minimum of three (3) years of communications or customer service experience in a managed care environment
- Bilingual in Spanish, Chinese or Korean required; speaking, reading and writing
- High School Diploma or equivalent required, Bachelor's degree preferred
- Excellent communication skills, both written and verbal.
- Computer literate
- The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer.
- Flexible Hybrid or Remote Position.
- Local candidates only.
We’re Making Healthcare Right. Together.
We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.