Member Services Advisor

CenterWell Primary Care$104K — $143K *
US-AnywhereRemote in South Carolina, US
Business Services
8 - 10 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree
  • Reside in South Carolina
  • Up to 10% travel to Columbia SC
  • 8+ years in consumer operations
  • 2+ years in project leadership
  • Experience in optimization and automation solutions
  • Strong analytical skills for program evaluation
  • Strategic planning and organization expertise

Responsibilities

  • Serve as member advocate and coordinate communications
  • Address coordination of issues within the organization
  • Resolve member inquiries and meet resolution standards
  • Assist members in accessing quality healthcare services
  • Develop functional strategies to enhance performance and consumer experience
  • Identify opportunities for member engagement improvement
  • Lead the Member Experience Workgroup and oversee market performance metrics

Benefits

  • Comprehensive medical, dental, and vision coverage
  • 401(k) retirement savings plan
  • Generous paid time off and company holidays
  • Paid parental and caregiver leave
  • Short-term and long-term disability insurance
  • Life insurance and additional wellness opportunities
Full Job Description
The Member Services Advisor (Consumer Experience Lead) role focuses on membership growth, member retention, and enhancing the overall member experience.
In this role, you will leverage the voice of the customer through NPS insights, root cause analysis, storytelling, call listening, and member experience design. You will identify and eliminate friction points, uncover automation and optimization opportunities, and empower others across the organization to raise concerns and advocate for improvements that enhance the member experience.
As a member of the South Carolina market team, you will report to the Regional VP of Operations.

The Consumer Experience Lead is responsible for developing and executing strategies that improve member engagement, retention, satisfaction, and overall experience, while maintaining direct ownership of key market KPIs and performance metrics. In this role, you will lead the Member Experience Workgroup, drive Go365 engagement and utilization, oversee member benefits, services, and incentives, and serve as the market point of contact for Member/Provider Services, Transformation, Enrollment, and G&A/Critical Inquiry teams. You will also develop strategies to improve CAHPS survey performance.

As a Consumer Experience Lead, you will provide cross-functional leadership and drive measurable improvements in consumer experience outcomes and contractual performance.

Role Overview:
  • Serve in the role of member advocate, coordinate communications with members.
  • Coordinate issues with appropriate areas within the organization.
  • Resolve member inquiries/problems and meet standards for resolution, telephone abandonment rates and telephone hold times; and assist members to access culturally competent, high quality integrated medical and Behavioral Health care.
  • Advise executives to develop functional strategies (often segment specific) on matters of significance.

Required Qualifications
  • Bachelor's degree
  • Must reside in the state of South Carolina
  • Ability to travel up to 10% to Columbia SC for business
  • 8 or more years of consumer operations experience
  • 2 or more years of project leadership experience
  • Develop functional strategies to improve performance and consumer experience
  • Experience identifying optimization and automation solutions to develop and launch company initiatives
  • Experience with analytics, including program evaluation and optimization
  • Strategic thinking and planning capabilities; organized and detail-oriented

Preferred Qualifications
  • Graduate degree preferred
  • History of Clinical Program Valuation preferred
  • Knowledge of Humana's internal policies, procedures and systems


Work at Home Requirements: To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$104,000 - $143,000 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About CenterWell Primary Care

CenterWell Primary Care Careers

Joining CenterWell Primary Care presents an unparalleled opportunity to advance one's career in a leading healthcare organization that is dedicated to innovation and quality care. CenterWell Primary Care is actively seeking professionals who are passionate about making a difference in the healthcare industry.

Explore Job Opportunities

CenterWell Primary Care offers a variety of job opportunities that enable professionals to grow their careers in an environment that values leadership and diversity. The company is committed to fostering a culture where innovation thrives and leadership skills are honed.

Professional Growth and Development

At CenterWell Primary Care, career growth is a priority. The company supports professional development through comprehensive training programs and opportunities for advancement. Employees are encouraged to expand their skills and knowledge, positioning themselves as leaders in the healthcare sector.

Diversity and Inclusion

CenterWell Primary Care is dedicated to creating a diverse and inclusive workplace. The company believes that diversity training and an inclusive culture are key to innovation and the delivery of exceptional care. Employees from various backgrounds bring unique perspectives that enhance the team's performance and patient outcomes.

Benefits and Culture

Employees at CenterWell Primary Care enjoy a range of benefits designed to support their professional and personal lives. The company's culture is centered on teamwork, respect, and integrity, providing a solid foundation for personal growth and job satisfaction.

Internship Programs

For those starting their career, CenterWell Primary Care offers internship programs that provide hands-on experience in the healthcare field. Interns gain valuable insights and skills, which are crucial for building a successful career in healthcare.

Hiring Process

The hiring process at CenterWell Primary Care is designed to identify candidates who are not only skilled but also passionate about making a difference in healthcare. Prospective employees can expect a thorough interview process where they can showcase their skills and learn more about the company's mission and values.

Networking and Professional Opportunities

CenterWell Primary Care encourages its team to engage in networking opportunities within and beyond the company. This engagement fosters professional connections and collaborative opportunities that can lead to innovative solutions and enhanced patient care.

Join the Team

CenterWell Primary Care is looking for curious, creative, and solution-driven team players. Search open positions that match your skills and interests on the CenterWell Primary Care Jobs page. Tailor your resume to reflect your expertise and prepare for a career that promises both professional and personal growth.

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Explore Careers at CenterWell Primary Care

Discover the rewarding opportunities awaiting at CenterWell Primary Care. With a commitment to employee growth, a diverse culture, and a drive for innovation, CenterWell Primary Care is the perfect place to advance your career in healthcare.
Learn more about CenterWell Primary Care
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