Member Advocate - PBM - Remote

Maxor National Pharmacy Services, LLC•Plano, TX

4d•$17 - $23•Remote

About The Position

VytlOne (formerly MaxorPlus) is currently seeking highly motivated and empathetic Member Advocates to join our dynamic, growing operations team. As the voice of our brand, this role handles complex customer inquiries that require a human touch, leveraging system and tools to provide efficient and personalized solutions. The ideal candidate thrives in a fast-paced environment, has strong critical thinking skills, and is passionate about turning challenging interactions into positive brand-building opportunities. The Member Advocate is responsible for establishing and maintaining relationships with members on behalf of the company by taking personal and complete responsibility for each member-related contact and by ensuring that all member and client requirements are completely met. As a Member Advocate, you are the primary internal representative of our organization; you must convey to the caller (member, pharmacy, provider, client or other) a sense of expertise in our services. This is a remote-based position within the Continental US.

Requirements

High school diploma, GED, or equivalent
2+ years Pharmacy or Health Care customer service experience.
Empathy and emotional intelligence: Strong interpersonal skills to build rapport, actively listen, and tailor service to member emotions and intent.
Communication skills: Excellent verbal and written communication skills, with a professional, collaborative, and friendly demeanor.
Problem-solving aptitude: A proactive and efficient problem-solver who can think through complex situations and offer creative, effective solutions.
Coachable mindset: Must be open to receiving feedback on performance which will be provided by the quality team, team leads, supervisors, manager and VP.
Technical competency: Proficiency with computers and the ability to navigate multiple systems simultaneously, including CRM, AI tools, and Contact Center software.
Resilience: The ability to manage stress and stay composed, especially in challenging situations.
Reliability: Punctuality and dependable attendance are essential to meet operational needs.
Adaptability: Ability to learn new skills, tasks, and technology.
Team Oriented: Strong ability to integrate into a team environment, collaborate with diverse work styles, and positively contribute to organizational culture.
AI proficiency: A tech-forward mindset and the ability to leverage AI-powered platforms and digital tools to enhance efficiency.
Scheduling flexibility is a requirement; may be required to work rotating shifts, including Holidays, weekends, and nights. Some overtime may be required.
A reliable, high-speed internet connection (preferably wired), a dedicated, distraction free workspace, and proficiency with remote communication tools are essential.
You will be provided with all the tools needed to perform your role, including dual monitors, laptop, and headset.

Nice To Haves

Experience with PBM Contact Center, Chat Support, AI and CRM technologies.

Responsibilities

Customer engagement: Field complex inbound inquiries, emails, and chat messages with professionalism and empathy.
Problem resolution: Efficiently and creatively resolve customer complaints, escalating complex issues to the appropriate channels when necessary.
Job Knowledge: Maintain deep job and service knowledge to confidently and accurately educate and serve members according to VytlOne standards.
Performance management: Meet or exceed key performance metrics to include, but not limited to: QA Scores Member Satisfaction Survey Scores Average Handle Time (AHT) Schedule Adherence Attendance Standards
Adaptability: Remain flexible and composed while navigating different member personalities, unpredictable call volumes, and changing procedures.
Data management: Maintain meticulous and accurate records of customer interactions within the CRM and AI tools, contributing valuable data for process improvement.
Process improvement: Proactively identify trends in customer feedback and issues, providing insights to management to streamline processes and enhance the member experience.
AI collaboration: Partner with AI-powered tools (e.g., AI copilots, knowledge bases) to access real-time information, generate call summaries, and personalize member interactions.
Communication: Maintain an open line of communication with all team members, including Member Services Management, and Lead Member Advocate.
Ongoing Training: Attend and participate in programs and meetings required by VytlOne and/or Member Services Department.
Compliance: Promptly report any allegations of impropriety to the Compliance Department. Comply with VytlOne’s Ethical Business Conduct policy and VytlOne’s Compliance Program. Remain free from exclusion under the OIG and SAMS Medicare/Medicaid lists.
Perform other job-related duties as assigned.

Benefits

At VytlOne we offer a diverse and inclusive work culture that supports a flexible work model in a collaborative, innovative team-oriented environment. You’ll work with a mission-driven organization focused on improving healthcare outcomes.
Enjoy competitive compensation, a comprehensive health benefits package, and a supportive team environment including:
Comprehensive mental health and wellbeing resources
Nationwide Blue Cross Blue Shield PPO with employee-friendly plan design, including a $850 individual annual medical deductible and $25 office visit copays, with low biweekly premiums
Company-paid basic life/AD&D, short-term and long-term disability insurance
Rx, dental, vision, other voluntary benefits, and FSA
Employer-matched 401k Plan
Industry-leading PTO plan
And more!

Stand Out From the Crowd

Upload your resume and get instant feedback on how well it matches this job.

Upload and Match Resume