Member Retention Advocate

5 days ago

New York, New York, United States MetroPlusHealth Full time

At MetroPlusHealth, we are seeking a highly skilled Member Retention Advocate to join our team.

The successful candidate will be responsible for supporting MetroPlusHealth members and other key stakeholders across the customer's journey.

This role requires the ability to quickly route members to the appropriate resolution and support, utilizing expertise on the system and understanding of NYSOH processes.

The Member Retention Advocate will work as a liaison to ensure proper processes are introduced and implemented, enhancing the MetroPlusHealth experience.

Key responsibilities include:

Recertification/Renewal of Membership

  1. Assist all lines of business (Medicaid/Medicare/MLTC/CHP/EP) in retaining current qualified members by following a strategic daily work schedule that includes am and pm hours, field locations as well as weekends.
  2. Follow appropriate processes to meet and exceed recertification targets set by the department.
  3. Make the recertification process as easy and seamless as possible for our members.
  4. Assist members with completion of recertification applications.
  5. Partner with different parts of the organization to understand any barriers to the member's experience and work to resolve them appropriately.
  6. Maintain daily Outreach and Renewal goals set through business needs to increase overall retention.

Enrollment and Retention Support

  1. Assist members with completion of all enrollment activities, including changing lines of business to ensure members are in the optimal plan, re-enrolling members due to administrative issues, premium payment, etc.
  2. Assist members with PCP selection as well as locating providers and vendors within the plan's network.
  3. Provide end-to-end customer support to drive customer satisfaction and improve customer experience.
  4. Interface with internal and external stakeholders to ensure complete resolution.
  5. Communicate verbally and in writing with members for all necessary Member Retention activities.

Process Improvements

  1. Devising solutions in response to member dissatisfaction/complaints/issues to support ongoing organizational improvement efforts.
  2. Support any ad-hoc projects on process improvements.
  3. Report common trends identified during member outreach.
  4. Other duties as assigned.

Requirements

The ideal candidate will possess:

Education and Experience

  1. Associate's Degree and minimum 1 year of experience in direct consumer contact, including customer engagement, customer services, sales, community engagement, etc.
  2. High school degree and 3-5 years of experience in direct consumer contact, including customer engagement, customer services, sales, community engagement, etc.
  3. Healthcare experience, especially in Managed Care, is preferred but not required.
  4. Bilingual skills are preferred.

Licensure and/or Certification Required

  1. The candidate must obtain Certified Application Counselor (CAC) certification within the first month of employment. MetroPlusHealth will facilitate the training and certification process.

Professional Competencies

  1. Functional/Technical skills
  2. Highly organized with attention to detail
  3. InTEGRITY and trust
  4. Customer Experience Focus
  5. Emotional intelligence-listening skills to really be able to work with members
  6. Written and Oral Communication skills
  7. Conflict Resolution
  8. Patience
  9. Problem-solving skills

Estimated annual salary: $65,000 - $90,000, depending on experience and qualifications. Located in New York, NY area.

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