Retention & Eligibility Advisor

Job not on LinkedIn

🔥 53 minutes ago

🦞 Maine – Remote

🦞 Maine – Remote

💵 $28 - $35 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

👻 Ghost score 0%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Martin's Point Health Care

WebsiteLinkedInAll Job Openings

501 - 1000 employees

🛡️ Insurance

📦 Logistics

💼 Consulting

Insurance • Logistics • Consulting

Martin's Point Health Care is a healthcare organization committed to serving its local communities through high-quality primary and specialty care services. The organization places a strong emphasis on creating a positive workplace culture, recognizing employee contributions, and fostering workforce diversity. Martin's Point Health Care offers a range of career opportunities across various departments, from healthcare providers to corporate roles, and supports employee growth through competitive compensation, development programs, and generous perks. Additionally, the company is recognized for its community impact efforts, raising significant funds for community organizations and encouraging employee volunteerism.

📋 Description

• Oversee all aspects of the USFHP member retention program • Communicate with members to support continued enrollment • Identify and track disenrollment reasons and trends • Develop and recommend policies and procedures focused on member satisfaction and retention • Analyze disenrollment reports, complaint and grievance data, and member feedback • Coordinate outreach to pending disenrolling members • Collaborate with the Enrollment Department on member disenrollment issues • Create and present member educational seminars and presentations • Support training and quality initiatives • Conduct disenrollment exit interviews and provide best-practice recommendations to senior management • Present business cases promoting retention strategies and evaluate campaign results • Develop retention strategies based on consumer feedback • Collaborate with the internal growth team on retention campaigns • Coordinate loyalty and retention programs to win back, reward, and retain members • Act as a liaison between members and health plan teams • Collaborate with the member service escalation team to resolve issues quickly • Write and present consumer behavior reports in the CRM database • Conduct fact-finding discussions to determine dissatisfaction reasons and attempt member retention • Process disenrollment requests in the CRM • Follow Department of Defense, Defense Health Agency, and state policies, procedures, laws, and guidelines • Develop and maintain monthly disenrollment and retention reports with BI analysts • Supplement outbound call volume when needed

🎯 Requirements

• Associate’s degree or equivalent combination of education and experience • 3+ years of experience with Tricare or USFHP • Experience working directly with health plan beneficiaries • Deep knowledge of TRICARE benefit preferred • Understanding of managed care concepts • Excellent telephone and interpersonal skills required • Strong commitment to customer service required • Must be able to work efficiently and independently • Must be analytical in research and problem resolution • Strong computer skills, keyboard proficiency, quick data entry, and high accuracy • Able to work cooperatively with other departments • Ability to multitask and prioritize • Well organized with excellent follow-up skills • Ability to handle crisis situations and adapt to change • Ability to design work processes around customer needs and expectations • Ability to establish accountability • Not eligible for immigration sponsorship

🏖️ Benefits

• Medical insurance • Dental insurance • Vision insurance • Retirement savings with employer contributions • Paid time off • Volunteer time off • Pie day • Other employee benefits • Potential additional incentive or commission-based compensation, where applicable