Member Engagement Specialist (BILINGUAL)
National Healthcare Solutions Group, Inc.
Member Engagement Specialist
The Member Engagement Specialist plays a key role in driving enrollment and sustained engagement in VerusRx's VerusPath program. This individual will guide members through the international pharmacy program enrollment process, ensure timely medication delivery, and support a seamless onboarding experience for new client groups—both virtually and through occasional on-site visits. The role also partners cross-functionally to optimize cost-saving opportunities and enhance member satisfaction.
Duties And Responsibilities
International Pharmacy Program Enrollment
- Enroll members under the VerusRx benefits plan in the International Pharmacy Program.
- Confidently explain the enrollment process and set clear expectations for medication delivery timelines.
- Educate members, groups, and clients on VerusPath and its benefits.
- Accurately track call records and logs within a CRM system.
- Maintain personal metrics, maintain statistics, and track all aspects of the enrollment process.
- Collaborate with internal teams to ensure a high-quality member experience when utilizing VerusPath.
Implementation Process Integration
- Lead the process when a new group starts with VerusRx.
- Work directly with internal stakeholders to ensure all new clients are onboarded successfully.
- Review claims files for eligible VerusPath medications and ensure claims are uploaded into the CRM.
- Maintain an organized approach to new clients starting, i.e. start date, life counts, claims, etc.
- Meet with clients and brokers to give an overview of the VerusPath program.
- Continuously improve our process for onboarding new groups.
On Site Enrollment
- Attend on-site enrollments to enroll members in the international pharmacy program.
- Discuss VerusPath on site at a client location and educate members.
- Provide a point of contact for a client if any issues arise.
Pre-Launch and Post Implementation Reporting
- Provide pre-launch and post launch reporting to groups to keep them informed on their cost savings to date.
- Send weekly enrollment and escalation reports during the onboarding process.
- Provide continuous savings analysis and enrollment reports to current clients.
Success Metrics Include
- Member enrollment success rate.
- Medication fulfillment and orders shipped.
- Client and member satisfaction ratings.
- VerusPath program savings achieved.
May perform other duties as required.
Minimum Qualifications (Knowledge, Skills, And Abilities)
- Bachelor's degree in Health Sciences, Public Health, Business Administration, Marketing, Pharmacy, or a related field preferred.
- 0–2 years of relevant work experience in healthcare, sales, marketing, pharmacy, insurance, or a corporate/administrative setting.
- Fluent in Spanish, both written and verbal, required.
- Internship or academic project experience in pharmacy benefits, sales, marketing, managed care, or healthcare operations is a plus.
- Strong analytical and problem-solving skills with attention to detail.
- Strong organizational skills.
- Excellent written and verbal communication skills.
- Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint, Outlook).
- Ability to manage multiple tasks and meet deadlines in a fast-paced environment.
- Sales-focused mindset with the ability to work collaboratively in a team.
- Problem-solving outlook with a focus on delivering client-centric solutions.
- Familiarity with healthcare terminology, pharmacy claims, or benefits administration is a plus.
- Exposure to PBM industry or pharmacy operations through coursework, internship, or previous employment is a plus.
- Understanding of HIPAA regulations and healthcare data privacy.
Note
This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise.
The Company complies with employment regulations as they apply to the location of service.
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