Medicare Member Experience Manager

Centene Corporation

About The Position

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Oversees the member experience through the lens of voice of the customer and other key experience value drivers. Leverage LEAN/Six Sigma methodologies and KPI tracking to identify issues, uncover root causes, gaining in-depth insights into the underlying factors shaping the member experience. The role extends beyond observation to drive continuous improvements, perpetually enhancing the member journey to meet ever-changing expectations and business goals. Collaborates closely with Member Research & Insights, Product, Sales, Network, Contact Center, internal business unit leaders, and other Shared Service partners to align the end-to-end experience with overarching member Experience objectives. Provides strategic oversight and direction in monitoring and analyzing the comprehensive end-to-end member journey. Leverages data and initiating high-impact research to proactively identify pain points and uncover unmet needs, ensuring a seamless experience across all touchpoints. Leads cross-functional collaboration to develop solutions that improve the member experience with the health plan. These solutions should reflect in-depth research and insights, capturing complex demographic trends, behaviors, and pain points, to guide strategic decision-making across the organization. Leads initiatives to resolve member pain points across key priorities (new member journeys, renewing member journeys, aligned dual member experience, getting care, benefit usage, digital tool interaction and Call Center experience) by analyzing complaint trends across member types, implementing targeted retention strategies and partnering across teams to improve satisfaction and reduce disenrollment. Partners with senior stakeholders to diagnose and address critical friction points. Lead cross-functional teams, including Product, Operations, and Shared Services, in prioritizing and executing high-impact enhancements that significantly elevate the overall member experience. Serves as a key strategic partner to the Digital Product team and internal business unit leaders. Recommend and advocate for innovative capabilities and experience enhancements, grounded in deep insights from member experience data, to influence the long-term experience strategy of Medicare. Performs other duties as assigned. Complies with all policies and standards.

Requirements

Bachelor's Degree in Healthcare Administration, Business a related field or equivalent experience required.
4+ years Experience with KPI development, using performance dashboards and reports, and project management software required.
Advanced level of problem solving and critical thinking to assess issues from multiple perspectives, the ability to assimilate information from diverse sources, translate insights into clear implications and implement sustainable improvements required.
Knowledge of CMS regulatory, Complaint and Grievance processes, healthcare delivery, Data analysis and reporting, CRM and call center platforms, Survey and feedback tools preferred.
Workflow and project management tools, Digital communication tools, Lean/Six Sigma methodologies or other process/continuous improvement strategies preferred.

Nice To Haves

Knowledge of CMS regulatory, Complaint and Grievance processes, healthcare delivery, Data analysis and reporting, CRM and call center platforms, Survey and feedback tools preferred.
Workflow and project management tools, Digital communication tools, Lean/Six Sigma methodologies or other process/continuous improvement strategies preferred.
CSSBB - Six Sigma Black Belt or Green Belt or other project management tools preferred.

Responsibilities

Oversees the member experience through the lens of voice of the customer and other key experience value drivers.
Leverage LEAN/Six Sigma methodologies and KPI tracking to identify issues, uncover root causes, gaining in-depth insights into the underlying factors shaping the member experience.
Drive continuous improvements, perpetually enhancing the member journey to meet ever-changing expectations and business goals.
Collaborates closely with Member Research & Insights, Product, Sales, Network, Contact Center, internal business unit leaders, and other Shared Service partners to align the end-to-end experience with overarching member Experience objectives.
Provides strategic oversight and direction in monitoring and analyzing the comprehensive end-to-end member journey.
Leverages data and initiating high-impact research to proactively identify pain points and uncover unmet needs, ensuring a seamless experience across all touchpoints.
Leads cross-functional collaboration to develop solutions that improve the member experience with the health plan.
Leads initiatives to resolve member pain points across key priorities (new member journeys, renewing member journeys, aligned dual member experience, getting care, benefit usage, digital tool interaction and Call Center experience) by analyzing complaint trends across member types, implementing targeted retention strategies and partnering across teams to improve satisfaction and reduce disenrollment.
Partners with senior stakeholders to diagnose and address critical friction points.
Lead cross-functional teams, including Product, Operations, and Shared Services, in prioritizing and executing high-impact enhancements that significantly elevate the overall member experience.
Serves as a key strategic partner to the Digital Product team and internal business unit leaders.
Recommend and advocate for innovative capabilities and experience enhancements, grounded in deep insights from member experience data, to influence the long-term experience strategy of Medicare.
Performs other duties as assigned.
Complies with all policies and standards.