Member Retention Representative

Performs outreach to identified new and existing members to help navigate positive experiences with the Health Plan and ensure member satisfaction to minimize rapid disenrollments. Advocates will assist by resolving escalations and complex issues and eliminate service interruptions to retain members. Works under moderate supervision.

$25.46 - $31.86 Hourly

What We Provide

• Referral bonus opportunities
• Generous paid time off (PTO), starting at 20 days of paid time off and 9 company holidays
• Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
• Employer-matched retirement saving funds
• Personal and financial wellness programs
• Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
• Generous tuition reimbursement for qualifying degrees
• Opportunities for professional growth and career advancement
• Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities

What You Will Do

• Conduct outbound calls to identified “At Risk” members to encourage continued enrollment by ensuring member satisfaction with their current services and address any issues they may have
• On Boarding new enrollees into VNS Health, including assisting with OTC card activation, PCP assignment, verifying contact information, reviewing benefits and guiding them through the plan design.
• Work as a liaison between the Sales/Marketing team and new enrollees to address any issues that arise during after enrollment.
• Participate in VNS Health Member Health Fairs, including member registration, answering questions and providing support during the event.
• Provide on-site presence at VNS Health locations to aid and support, ensuring any issues identified during these visits are addressed. Collaborate with Health Plan teams to resolve member issues and immediately address member dissatisfaction.
• Capture relevant data related to member dissatisfaction and disenrollment and provide internal feedback on how to improve Member Retention. Identify opportunities for process improvements.
• Ensure a high level of customer satisfaction through proactive support and active listening.
• Performs all duties within CMS guidelines, following all rules and regulations and stays up to date on all new marketing policies.
• Develops and maintains knowledge of products, services and systems as required.
• Participates in special projects and performs other duties as assigned.

Licenses and Certifications:

• Medicare License preferred

Education:

• Bachelor's Degree or equivalent work experience preferred

Work Experience:

• Minimum of two years of experience working with customers in customer service, medical or managed care environment required
• Excellent verbal and written communication skills required
• Willingness to attend appropriate training and certification classes required
• Connecting customers with resources required
• Ability to demonstrate excellent service knowledge and hospitality required
• Possesses optimistic warmth and empathy for the customers’ experience required
• Technologically savvy, with the ability to quickly learn and navigate different information technology systems required
• Flexibility to travel to, and work in a physical office site when needed required
• Bi-lingual skills preferred
• Experience communicating directly with customers, assessing needs, and Knowledgeable on how to navigate all aspects of medical care and managed care system, health, and wellness preferred