Member Engagement Guide - Remote in Central PA.

Highmark Health•State College, PA

23h•Remote

About The Position

This role is remote and located in the Central PA territory, covering areas such as Harrisburg, Carlisle, York, Mechanicsburg, Lancaster, and State College. The position collaborates with Sales Client Management and the Sales Executive team to develop member transition strategies, guiding members to AHN and community providers to minimize future disruption. The role involves educating members on their insurance benefits, the financial impact of healthcare choices, available provider/service options, and the importance of timely and appropriate care. The incumbent will significantly influence member behavior and drive business outcomes from a cost of care perspective.

Requirements

3 years of prior sales or client consulting experience, preferably in the Insurance industry
Strong relationship builder across multiple levels of an organization from employee through senior leader
Strong communication and influence skills across levels of an organization from employee through senior leaders
Able to work effectively in a matrix environment
Able to juggle and manage competing priorities
Strong presentation and written communication skills
Strong analytical skills /financial acumen
Compliance with ethical and legal standards, code of business conduct, and company policies.
Compliance with HIPAA, Privacy Policies and Procedures, data security guidelines, and Information Security Policy.
Compliance with the company's Code of Business Conduct, applicable federal and state laws, rules, and regulations, and company policies and training requirements.

Nice To Haves

Producer License in Life, Accident & Health

Responsibilities

Empower members to make informed decisions by evaluating the most appropriate type of provider for their unique needs, assessing in-network providers, and ensuring members are fully informed of available tools and resources to transition to AHN or other community providers.
Advocate for the member by providing assistance with transferring medical records, making prompt appointments with AHN or other community providers, and assisting with resolving claim or billing issues.
Educate members about access to comprehensive clinical care and demonstrate the quality of care and advanced outcomes of partner network providers.
Assist members in engaging medical care from higher quality, more cost-effective providers closer to their homes.
Create new and innovative opportunities for members to interact with patient-focused providers and experience the quality of care firsthand for various specialties.
Showcase the latest developments in quality of care and the results of investments from AHN and community partner providers.
Demonstrate business acumen by partnering with and developing proactive sales strategies with the Organization's Sales team, and executing these strategies by influencing member buying decisions at enrollment events focused on maintaining and increasing enrollment and profitability.
Participate in the development of sales strategies with the Organization's Sales Team, and execute those strategies in sales situations by influencing member buying decisions to purchase supplemental Lines of coverage for growth and/or retention of contracts and increase profitability for HMIG products along with the dental and vision companies on a regional and national basis.
Schedule and facilitate meetings with employers, members, and AHN and community provider partners.
Identify and research operational issues based on member/client feedback and transition details to the appropriate internal department (including but not limited to Product Management, membership, claims, eMarketing, etc.).
Identify opportunities for process improvements.
Drive changes in member behaviors by developing strategies that influence change and create action from benefit executives and individual members, including development of incentive models, creating connections and relationships between executives at the Organization, employer organizations, and demonstrating the financial impacts of decisions for employers and members.
Other duties as assigned or requested.