Consumer Service Ops Professional

Humana • Work at Home - Kentucky, KY

5d • $58,700 - $68,200 • Remote

About The Position

The Consumer Service Operations Professional 2 is responsible for the daily coordination of member support and benefit fulfillment activities across multiple service responsibilities. You will support members by resolving service needs, coordinating benefit delivery, facilitating assistance programs and collaborating with internal and external partners to achieve positive member outcomes. The Consumer Service Operations Professional 2 works, exercises, manages and contributes to ongoing operational improvements. Work assignments are varied and frequently require interpretation, and independent determination of courses of action. The Consumer Service Operations Professional 2 may support benefit installation, implementation, and market operations, ensuring the successful administration and oversight of member benefits.

Requirements

• Bachelor's degree or equivalent work experience
• 3 years experience in a service operations environment
• Must be passionate about contributing to an organization focused on improving consumer experiences
• 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.
• Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Nice To Haves

• Benefit or Program implementation experience
• Experience with healthcare or benefit administration
• Experience analyzing operational data and metrics to identify trends, support decision-making and communicate insights to
• Quality assurance, auditing or continuous improvement experience
• Project Management experience

Responsibilities

• Investigate and resolve member, provider and customer service issues.
• Coordinate fulfillment of member benefits and resources, including researching products, identifying solutions and arranging delivery.
• Collaborate with internal partners to address member needs and ensure service excellence in benefit administration and fulfillment.
• Coordinate with internal and external partners to facilitate benefit fulfillment, resolve barriers and support member outcomes.
• Use benefit fulfillment systems multiple systems and data sources to process requests, maintain accurate records and support operational workflows.
• Analyze information, research problems and determine appropriate solutions while balancing quality, compliance and member experience.
• Monitor work activity and use operational data, reports and performance metrics to support decision-making and workload prioritization.
• Identify opportunities to improve processes, improve workflows and enhance the member experience.
• Support implementation of new programs, benefits, workflows or operational programs as assigned.
• Operate while exercising and judgment in prioritizing work and adapting established procedures to unique situations.
• Demonstrate for complex issues through resolution.
• Understand department, segment and organizational strategies and how they align with operational goals.
• Contribute to a culture of continuous improvement, teamwork and consumer experience.

Benefits

• medical
• dental
• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level