Member Services Advisor

Humana • Carolina, SC

11d • Remote

About The Position

The Member Services Advisor (Consumer Experience Lead) role focuses on membership growth, member retention, and enhancing the overall member experience. In this role, you will leverage the voice of the customer through NPS insights, root cause analysis, storytelling, call listening, and member experience design. You will identify and eliminate friction points, uncover automation and optimization opportunities, and empower others across the organization to raise concerns and advocate for improvements that enhance the member experience. As a member of the South Carolina market team, you will report to the Regional VP of Operations. The Consumer Experience Lead is responsible for developing and executing strategies that improve member engagement, retention, satisfaction, and overall experience, while maintaining direct ownership of key market KPIs and performance metrics. In this role, you will lead the Member Experience Workgroup, drive Go365 engagement and utilization, oversee member benefits, services, and incentives, and serve as the market point of contact for Member/Provider Services, Transformation, Enrollment, and G&A/Critical Inquiry teams. You will also develop strategies to improve CAHPS survey performance. As a Consumer Experience Lead, you will provide cross-functional leadership and drive measurable improvements in consumer experience outcomes and contractual performance. Role Overview: Serve in the role of member advocate, coordinate communications with members. Coordinate issues with appropriate areas within the organization. Resolve member inquiries/problems and meet standards for resolution, telephone abandonment rates and telephone hold times; and assist members to access culturally competent, high quality integrated medical and Behavioral Health care. Advise executives to develop functional strategies (often segment specific) on matters of significance. Use your skills to make an impact

Requirements

• Bachelor's degree
• Must reside in the state of South Carolina
• Ability to travel up to 10% to Columbia SC for business
• 8 or more years of consumer operations experience
• 2 or more years of project leadership experience
• Develop functional strategies to improve performance and consumer experience
• Experience identifying optimization and automation solutions to develop and launch company initiatives
• Experience with analytics, including program evaluation and optimization
• Strategic thinking and planning capabilities; organized and detail-oriented
• Self-provided internet service must meet the following criteria: 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

• Graduate degree preferred
• History of Clinical Program Valuation preferred
• Knowledge of Humana's internal policies, procedures and systems

Responsibilities

• Lead the Member Experience Workgroup
• Drive Go365 engagement and utilization
• Oversee member benefits, services, and incentives
• Serve as the market point of contact for Member/Provider Services, Transformation, Enrollment, and G&A/Critical Inquiry teams
• Develop strategies to improve CAHPS survey performance
• Provide cross-functional leadership and drive measurable improvements in consumer experience outcomes and contractual performance
• Serve in the role of member advocate, coordinate communications with members
• Coordinate issues with appropriate areas within the organization
• Resolve member inquiries/problems and meet standards for resolution, telephone abandonment rates and telephone hold times
• Assist members to access culturally competent, high quality integrated medical and Behavioral Health care
• Advise executives to develop functional strategies (often segment specific) on matters of significance

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