Resp & Qualifications PURPOSE: The Business Consultant, Retention Specialist, is a member of the Stars Member Experience team and provides expertise in critical work to help design, launch, and execute programs that support member experience and retention initiatives for Medicare Advantage members, driving improvement in Medicare CAHPS and HOS surveys.
We are looking for an experienced professional in the greater Baltimore/Washington metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst location based on business needs and work activities/deliverables that week.
ESSENTIAL FUNCTIONS: - Provide subject matter expertise in Medicare Advantage member experience and retention strategies.
- Integrate data across Customer Service, Appeals & Grievances, complaints, CAHPS, enrollment, clinical, vendors, and other operational areas to understand and action on key member experience, retention, and Stars performance drivers. Identify member pain points, including repeat callers, and trends seen across other operational data, and do root cause analysis.
- Lead implementation of enterprise improvement initiatives through project management, stakeholder coordination, and performance monitoring.
- Serve as the organization owner for driving member experience work that falls across operational teams.
- Develop dashboards to support clear communication across functional areas, monitor progress across multiple on-going initiatives.
- Business Consultant may do some member engagement/outreach work to members who provide negative survey results or have called in multiple times.
QUALIFICATIONS: Education Level: Bachelor's Degree OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
Experience: 5 years experience in business development, operational technology support, general business operations and/or consulting experience.
Knowledge, Skills and Abilities (KSAs) - Understands Medicare Advantage, member experience, Stars
- Follows evolving market, industry and consumer trends.
- Understands healthcare operations.
- Exceptional project management, facilitation and organizational skills.
- Understands healthcare claims, survey, clinical, and health data.
- Strategic thinker, problem solver, and a collaborator who can drive engagement and discussions.
- Advanced proficiency in Microsoft Excel and experience using business intelligence and reporting tools (i.e., Power BI), and preferred ability to conduct more advanced analysts using SQL, Python, or similar.
- Ability to synthesize quantitative data and qualitative feedback into clear, actionable business.
Salary Range: $88,848 - $176,462
Salary Range Disclaimer The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).
PHYSICAL DEMANDS:The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.
Sponsorship in US Must be eligible to work in the U.S. without Sponsorship
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