Member Services Advisor

🕒 October 20

🌴 South Carolina – Remote

🌴 South Carolina – Remote

💵 $104k - $143k / year

⏰ Full Time

🟠 Senior

🔴 Lead

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Focus on membership growth, member retention, and enhancing the overall member experience • Leverage NPS insights, root cause analysis, storytelling, call listening, and member experience design • Identify and eliminate friction points • Uncover automation and optimization opportunities • Empower others across the organization to raise concerns and advocate for member experience improvements • Develop and execute strategies to improve member engagement, retention, satisfaction, and overall experience • Maintain direct ownership of key market KPIs and performance metrics • Lead the Member Experience Workgroup • Drive Go365 engagement and utilization • Oversee member benefits, services, and incentives • Serve as the market point of contact for Member/Provider Services, Transformation, Enrollment, and G&A/Critical Inquiry teams • Develop strategies to improve CAHPS survey performance • Provide cross-functional leadership and drive measurable improvements in consumer experience outcomes and contractual performance • Serve as a member advocate and coordinate communications with members • Coordinate issues with appropriate areas within the organization • Resolve member inquiries and problems • Meet standards for resolution, telephone abandonment rates, and telephone hold times • Assist members in accessing culturally competent, high-quality integrated medical and Behavioral Health care • Advise executives on functional strategies concerning significant matters • Report to the Regional VP of Operations

🎯 Requirements

• Must reside in the state of South Carolina • Ability to travel up to 10% to Columbia, South Carolina for business • 8 or more years of consumer operations experience • 2 or more years of people or project leadership experience • Ability to 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 • Bachelor's degree preferred • History of Clinical Program Valuation preferred • Knowledge of Humana's internal policies, procedures and systems

🏖️ Benefits

• Bonus incentive plan based on company and/or individual performance • Medical benefits • Dental benefits • Vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Personal wellness support • Healthcare decision support

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