Medicare Member Engagement Representative

SummaCare E Market St, Akron, OH 44305

Full-time / 40 Hours / Days

TEMPORARY POSITION

Summary :

Completes Medicare Advantage plan changes over the phone utilizing a compliance approved script. Documents all calls. Tracks and follows-up with SummaCare Medicare members at risk for disenrollment from the health plan. Assists with outreach programs designed to increase retention of SummaCare Medicare members. Acts as support when presenting plan benefit information to groups or individuals in person, as needed. Complies with Center for Medicare and Medicaid Services (CMS) rules and regulations related to Medicare Advantage plans.

Formal Education Required :

a. High School Diploma or GED

b. Associate's or BA/BS preferred

Experience & Training Required :

a. One (1) year experience in a call center, customer service, or support role in the health insurance industry performing same or similar responsibilities which includes any combination of the following:

i. Customer service experience dealing with Medicare beneficiaries,

ii. Understanding of Medicare / health insurance compliance

iii. Working knowledge of Medicare, plan design and benefits

b. Two (2) years of experience in the health insurance industry strongly preferred

1. Other Skills, Competencies and Qualifications:

a. Possess working knowledge of Center for Medicare and Medicaid Services (CMS) rules and regulations related to Medicare Advantage plans

b. Ability to complete SummaCare plan and product training prior to open enrollment season with a passing rate of 90%.

c. Ability to multi-task. Operate computer, MACESS member documentation system, Plan Central, Salesforce CRM system, utilize SummaCare website and phone system while speaking and collecting information from member and when applicable prospective enrollee.

d. Excellent phone skills.

e. Strong understanding of Federal and State regulatory requirements and Marketing Guidelines.

f. Able to work independently and within a team environment.

g. Effective listening and critical thinking skills.

h. Ability to develop, prioritize and accomplish goals.

i. Demonstrate time management.

j. Moderate Complexity: Independent judgment, decision-making, problem solving related to programs and projects, technical systems; interpreting policies and procedures within and across departments.

k. Moderate Stress: Variety of work that is complex in nature; requires attention to detail; frequent interruptions and distractions; involves coordinating across departments. Accountable for personal performance and completion of projects across departments. Frequently required to calm and gain confidence of others.

l. Ability to travel from location to location throughout the workday.

m. Ability to effectively interact with populations of patients/customers with an understanding of their needs for self-respect and dignity

1. Level of Physical Demands:

a. Light: Exerts up to 20 pounds of force occasionally and/or up to ten pounds of force frequently, and/or a negligible amount of force continuously.

Equal Opportunity Employer/Veterans/Disabled

$15.96/hr - $25.00/hr

The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.

Summa Health offers a competitive and comprehensive benefits program to include medical, dental, vision, life, paid time off as well as many other benefits.

• Basic Life and Accidental Death & Dismemberment (AD&D)
• Supplemental Life and AD&D
• Dependent Life Insurance
• Short-Term and Long-Term Disability
• Accident Insurance, Hospital Indemnity, and Critical Illness
• Retirement Savings Plan
• Flexible Spending Accounts – Healthcare and Dependent Care
• Employee Assistance Program (EAP)
• Identity Theft Protection
• Pet Insurance
• Education Assistance
• Daily Pay