Membership Retention Specialist

Membership Retention Specialist

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility.

Process value added benefits that Medicaid members request. Manage purchase orders, invoices, and vendor relationships.

Position Purpose : The Membership Retention Specialist is responsible for activities related to strengthening customer relationships through member education relative to benefits and Plan usage and for local "high touch" outreach to improve membership retention of current and new Health Net Medicare Advantage, Part D members, CalMediConnect Members, etc.

Act 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.

Complies with all policies and standards.

Candidate must reside in the state of GA.

Skills & Experience :

• Medicaid knowledge
• Excellent customer service
• Attention to detail
• Manage external partner relationships
• 90% Remote and 10% travel for events and in office meetings / trainings

Education / Experience :

Bachelor's degree in Sales, Marketing or other related field preferred. Minimum three years in sales and / or marketing, preferably in health care environment. Medicaid experience strongly preferred. No licensure required.

Pay Range : $26.50 - $47.59 per hour

Centene offers a comprehensive benefits package including : competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.