Membership Retention Specialist

Membership Retention Specialist

Requirements

• Bachelor’s degree in Sales, Marketing or other related field preferred
• Minimum three years in sales and/or marketing, preferably in health care environment
• Medicare experience strongly preferred
• Current insurance license for state in which product is sold, or ability to obtain license within 45 days of hire

Responsibilities

• Acts as local resource and member advocate for members, supplementing the service work performed by the Customer Contact Center team
• May research CMC call sources, place outbound calls to CMC member or other service providers (e.g. pharmacist, physician office, etc.) to try and obtain updated contact information for the member
• Responds to escalated member issues and attempts resolution to enhance member experience and minimize controllable disenrollments
• Interfaces with the Customer Contact Center to address member issues by the specific member situation
• Assists members with special circumstances and works with Care Management to coordinate service needs for covered benefits
• Provides management with statistical data and market information regarding member issues and reports
• Hosts member informational meetings during Annual Enrollment Period/Open Enrollment Period (AEP/OEP)
• Facilitates member requests for ‘plan to plan’ changes during AEP/OEP
• Supports Sales during AEP/OEP, by interfacing with Field Sales Representatives, Seasonal Captive Agents and Sales Management team members
• Conducts new member orientation meetings to integrate new members into Health Net
• Provides education to existing and new members in person, over the telephone and through member meetings and other community outreach activities
• Develops relationships with senior centers, senior focused community organizations, contracted providers, and other community resources to facilitate higher levels of awareness and understanding of Health Net CMC product or Health Net Medicare Programs and the services and plans available in the Health Net of Arizona Medicare Advantage service area
• May promote the Health Net brand throughout the Medicare community and participate in various public relations opportunities
• Maintains and applies a high level of working knowledge regarding Centers for Medicare & Medicaid Services (CMS) regulations, particularly those related to Marketing and customer service
• Assists with plan change applications and ensures all necessary paperwork is completed and records are maintained
• Tracks and documents all member interactions, analyzes the associated data and makes recommendations to management to improve the customer experience
• Prepares reports from contact data regarding member retention activities and results in order to identify positive and adverse trends
• Participates in interdepartmental discussions and planning to evaluate procedures and processes and achieve company goals
• Performs other duties as assigned

Preferred Qualifications

• Highly Preferred – GA Residents