MEDICARE MEMBER ENGAGEMENT SPC, OUTBOUND

Molina Healthcare is hiring for several remote Medicare Member Engagement Specialists in our Outbound department. Bilingual (Spanish) not required but is a plus! This is a 100% remote role that will be working Pacific Standard Time. You must be able to work 8am to 430pm- Pacific Standard Time (PST) Monday through Friday.

This very important outbound customer service role is on the Medicare Concierge team.  This role will be responsible for outbound calls welcoming our members, ensuring they understand their benefits, educating on anything additional they may need, assisting with health-risk assessments, and other duties as assigned. 

The hours for this role will be 8am to 430pm- Pacific Standard Time (PST) Monday through Friday. 

Highly qualified applicants will have the following experience:

• Medicare knowledge/background or solid understanding how health insurance works.
• Medical knowledge and/or medical background.
• Strong customer service experience.
• Excellent communication skills which includes having empathy, and critical thinking skills.
• Must be intermediate or above using Microsoft Office products- Office, Excel, SharePoint etc.
• Knowledge of any of the following programs is very helpful- Salesforce, Epic, Clinical Care Advantage, Epic, Genesis, Member 360, QNXT .
• Must be able to multitask.
• Bilingual (any language) preferred but not required. Spanish is in high need.
• Work environment must be free from distractions and secure as you will be working with protected medical information.

Knowledge/Skills/Abilities

• Responsible for continuous quality improvements regarding member engagement and member retention. Represents Member issues in areas involving member impact and engagement including: New Member Onboarding, member plan benefits education, and the development/maintenance of Member Materials.
• Conducts direct outreach to new Medicare members to provide personal assistance with their new MAPD, DSNP, and MMP plans. Serves as an advocate to ensure members are well informed about plan benefits, provider options and how to use their new plan benefits.
• Serve as the member’s navigator during the onboarding process and address any plan questions and anticipate any issues that may arise. Determine the nature of the member’s needs and interests; inform members of their plan resources and benefits with a focus on the member’s area of interest/needs; and follow up with member to ensure needs are met and member is having a positive plan experience.  Develop relationship with member to be the go-to person with any future issues or questions.  
• Log all contacts in a database.
• Participate in Member engagement work groups as needed to ensure Medicare member needs are being anticipated and addressed.
• Participates in regular member benefits training with health plan, including the member advocate/engagement role.

Job Qualifications

REQUIRED EDUCATION:  High School diploma.
PREFERRED EDUCATION: Associate’s or Bachelor’s Degree in Social Work, Human Services, or related field.

REQUIRED EXPERIENCE: 2 years’ experience in customer service, consumer advocacy, and/or health care systems experience conducting intake, interviews, and/or research of consumer or provider issues. Excellent written and verbal communication skills to collaborate internally and externally with members, providers, team members, and manager.  Basic understanding of managed healthcare systems and Medicare.

PREFERRED EXPERIENCE: 2 years’ experience in customer service, consumer advocacy, and/or health care systems. Experience conducting intake, interviews, and/or research of consumer or provider issues. Excellent written and verbal communication skills to collaborate internally and externally with members, providers, team members, and manager.  Experience with Medicare and Medicare managed plans such as MAPD, DSNP, and MMP.

PHYSICAL DEMANDS:
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

Pay Range: $13.41 – $29.06 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.