Member Services Advisor

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

📋 Description

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

• Utilize NPS insights, conduct root cause analysis, engage in storytelling, listen to calls, and design member experiences.

• Identify and remove points of friction.

• Discover opportunities for automation and optimization.

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

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

• Maintain direct accountability for key market KPIs and performance metrics.

• Lead the Member Experience Workgroup.

• Drive engagement and utilization of Go365.

• Oversee member benefits, services, and incentives.

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

• Create strategies to enhance CAHPS survey performance.

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

• Advocate for members and coordinate communications with them.

• Address issues with the relevant departments within the organization.

• Resolve member inquiries and challenges.

• Meet standards for issue resolution, telephone abandonment rates, and hold times.

• Assist members in accessing culturally competent, high-quality integrated medical and Behavioral Health care.

• Advise executives on functional strategies regarding significant matters.

• Report to the Regional VP of Operations.

⛳️ Requirements

• Must reside in South Carolina.

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

• 8 or more years of experience in consumer operations.

• At least 2 years of experience in people or project leadership.

• Proven ability to develop functional strategies to enhance performance and consumer experience.

• Experience in identifying optimization and automation solutions for launching company initiatives.

• Proficiency in analytics, including program evaluation and optimization.

• Strong strategic thinking and planning skills.

• Highly organized and detail-oriented.

• Bachelor's degree preferred.

• History of Clinical Program Valuation 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.

• Personal wellness support.

• Healthcare decision support.