Quality Retention Specialist

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

📋 Description

• Assists our members with their disenrollment requests and ensures related quality assurance.

• Engages with a customer-centric approach and shows genuine concern for our members' needs.

• Addresses various customer-related issues and utilizes problem-solving skills to effectively manage call escalations.

• Acts as a “subject matter expert” for escalated member calls that are at risk of disenrollment.

• Identifies opportunities for process improvements within the Member Engagement department.

• Responsible for achieving and surpassing assigned monthly goals.

• Makes outbound calls and/or receives inbound calls within the department's targeted timeframe.

• Works collaboratively with our partners to enhance the member experience.

• Participates in mandatory team meetings and training sessions.

⛳️ Requirements

• Minimum of 1 year of experience in healthcare.

• At least 1 year of experience with Medi-Cal, Commercial, and Medicare Managed Care Plans and/or Sales, Customer Service, or Membership and Eligibility.

• Comprehensive knowledge of the Medicare Managed Care Manual Chapter 2 - Medicare Advantage Enrollment and Disenrollment, as well as Medicare Communications and Marketing Guidelines.

• Strong written and verbal communication skills; capable of building and maintaining positive relationships with diverse members, management, staff, and vendors; proficient in troubleshooting and problem-solving.

• High School Diploma or GED is required. A Bachelor's degree or four additional years of experience may be accepted in lieu of education.

• Bilingual proficiency in one of the following languages is preferred: Spanish, Vietnamese, Mandarin, Cantonese, or Korean.

🏝️ Benefits

• Comprehensive health benefits package.

• Opportunities for career advancement and professional development.

• Flexible working hours and a supportive work environment.