Member Services Advisor

This is a fully remote position, open to applicants in South Carolina.

📋 Description

• Focus on expanding membership, enhancing member retention, and improving the overall member experience.

• Utilize customer feedback through NPS insights, root cause analysis, storytelling, call listening, and member experience design.

• Identify and remove friction points.

• Discover opportunities for automation and optimization.

• Empower teams throughout the organization to voice concerns and advocate for enhancements in member experience.

• Report directly to the Regional VP of Operations as part of the South Carolina market team.

• Create and implement strategies aimed at boosting member engagement, retention, satisfaction, and overall experience.

• Manage key market KPIs and performance metrics.

• Lead the Member Experience Workgroup.

• Promote Go365 engagement and usage.

• Supervise member benefits, services, and incentives.

• Act as the market point of contact for Member/Provider Services, Transformation, Enrollment, and G&A/Critical Inquiry teams.

• Formulate strategies to enhance CAHPS survey performance.

• Provide cross-functional leadership and drive measurable improvements in consumer experience outcomes and contractual performance.

• Act as a member advocate and facilitate communication with members.

• Coordinate issues with the appropriate departments within the organization.

• Address member inquiries and issues while adhering to resolution, telephone abandonment, and hold-time standards.

• Support members in accessing culturally competent, high-quality integrated medical and behavioral health care.

• Advise executives on functional strategies concerning significant matters.

⛳️ Requirements

• Bachelor's degree required.

• Must reside in South Carolina.

• Willingness to travel up to 10% to Columbia, SC for business purposes.

• A minimum of 8 years of experience in consumer operations.

• At least 2 years of experience in project leadership.

• Capability to develop functional strategies to enhance performance and consumer experience.

• Proven experience in identifying optimization and automation solutions to implement company initiatives.

• Proficient in analytics, including program evaluation and optimization.

• Strong strategic thinking and planning skills.

• Highly organized and detail-oriented.

• Minimum home internet speed of 25 Mbps for download and 10 Mbps for upload.

• Ability to work from a dedicated space free from interruptions to maintain member PHI/HIPAA compliance.

• Graduate degree is preferred.

• A background in Clinical Program Valuation is preferred.

• Familiarity with Humana's internal policies, procedures, and systems.

🏝️ Benefits

• Bonus incentive plan based on company and/or individual performance.

• Medical benefits.

• Dental benefits.

• Vision benefits.

• 401(k) retirement savings plan.

• Paid time off.

• Company holidays.

• Personal holidays.

• Paid parental leave.

• Paid caregiver leave.

• Short-term disability.

• Long-term disability.

• Life insurance.

• Work-from-home arrangement.

• Requirement for a dedicated workspace to protect member PHI/HIPAA information.