Membership Representative II

Job Title

Candidates must live in one of the preferred 15 states (AZ, FL, GA, ID, IA, KY, MI, NE, NM, NY (outside greater-NYC), OH, TX, UT, WA (outside greater-Seattle), WI). Work hours: 8am to 4:30pm PST or CST.

Job Description:

Conduct retention outreach to existing members to educate the members on upcoming plan changes for the next year. Serves as an advocate to ensure members are well informed about plan and all questions or concerns have been resolved.

Conducts direct outreach to new Medicare members to provide personal assistance with their new Medicare plans. Serves as an advocate to ensure members are well informed about plan benefits, provider options and how to use their new plan benefits.

Serve as the member's navigator during the onboarding process and address any plan questions and anticipate any issues that may arise. Determine the nature of the member's needs and interests; inform members of their plan resources and benefits with a focus on the member's area of interest/needs.

Log all interactions in required systems.

Participates in regular member benefits training with health plan, including the member advocate/engagement role.

Must Have Requirements:

Medicare/Medicaid background is strongly preferred

Candidates must be able to navigate multiple systems

Customer services / consumer advocacy skills

Experience conducting intake, interviews, and/or research of consumer or provider issues.

Excellent written and verbal communication skills to collaborate internally and externally with members, providers, team members, and manager.

Basic understanding of managed healthcare systems and Medicare.

Required Experience:

2 years experience in customer service, consumer advocacy, and/or health care systems.

Required Education:

High School diploma.

Day to Day Responsibilities:

Member outreach via phone to existing members to explain benefit changes

Preferred Experience:

Call Center Experience

Work from Home Experience

Medicare and Duals Experience

Genesys Experience

Bilingual

Sales force and EPIC Experience

Microsoft Office Experience