Member Advocate - PBM - Remote

Maxor National Pharmacy Services, LLC • Plano, TX

3d • $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
• Required: 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.
• A reliable, high-speed internet connection (preferably wired), a dedicated, distraction free workspace, and proficiency with remote communication tools are essential.

Nice To Haves

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

Responsibilities

• Field complex inbound inquiries, emails, and chat messages with professionalism and empathy.
• Efficiently and creatively resolve customer complaints, escalating complex issues to the appropriate channels when necessary.
• Maintain deep job and service knowledge to confidently and accurately educate and serve members according to VytlOne standards.
• 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.
• Remain flexible and composed while navigating different member personalities, unpredictable call volumes, and changing procedures.
• Maintain meticulous and accurate records of customer interactions within the CRM and AI tools, contributing valuable data for process improvement.
• Proactively identify trends in customer feedback and issues, providing insights to management to streamline processes and enhance the member experience.
• Partner with AI-powered tools (e.g., AI copilots, knowledge bases) to access real-time information, generate call summaries, and personalize member interactions.
• Maintain an open line of communication with all team members, including Member Services Management, and Lead Member Advocate.
• Attend and participate in programs and meetings required by VytlOne and/or Member Services Department.
• 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

• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED