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Centene Corporation Membership Retention Specialist in Tempe, Arizona

Description - External

Position Purpose:

The Membership Retention Specialist is responsible for activities related to strengthening customer relationships through member education relative to benefits, Plan usage, providing excellent quality for “high touch” outreach to improve membership retention of current and New and Tenured WellCare and Centene Medicare advantage, DSNP and PDP.

  • Acts as local resource and member advocate for members, supplementing the service work performed by the Customer Contact Center team.

  • Handle escalated calls, resolving more complex customer issues

  • Demonstrate outstanding service to identify the source of the caller's issue and work to resolve the inquires in a timely and professional manner

  • Help guide and educate customers about the fundamentals and benefits of consumer - driven health care topics such as selecting the best benefit plan options, maximizing the value of their health plan benefits and choosing a quality care provider

  • Contact care providers (doctor's offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance

  • 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 disenrollment’s.

  • Assists members with special circumstances and works with Care Management to coordinate service needs for covered benefits.

  • 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.

  • Perform root cause analysis to identify key drivers of member disenrollment and work closely with management and process improvement teams to effect change, improve processes and move toward zero defects

  • Performs other duties as assigned.

Qualifications - External

Required Education/Experience

  • High School Diploma / GED Required

  • 3 years’ experience in sales and or marketing, preferably in health care environment

  • 1+ years of customer service experience or experience in a medical office, health care, call center or office setting analyzing and solving customer problems

  • Familiarity with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications

  • Ability to work Monday - Friday, 8 - hour shifts during business hours of 6:30 am - 6:00 pm MST, with flexibility to work occasional voluntary overtime

  • Bilingual in English/Spanish

Preferred Experience

  • Experience translating healthcare-related jargon and complex processes into simple, step - by - step instructions customers can understand and act upon

  • Prior healthcare experience

  • Experience with billing / finance and eligibility processes, practices, and concepts

  • Ability to listen skillfully, collect relevant information, build rapport and respond to customers in a compassionate manner

  • Experience in a position requiring conflict management skills including the ability to resolve stressful situations

Once work from home orders have been lifted, this person will be required to work in the local Tempe, AZ office.*

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.

TITLE: Membership Retention Specialist

LOCATION: Tempe, Arizona

REQNUMBER: 1241561

COMPANY: Corporate & Professional services