Business Consultant- Retention Specialist (Hybrid)

CareFirst BlueCross BlueShield; Baltimore (MD); Hybrid; USD 89,000 - 176,000; Full time

Job summary

CareFirst BlueCross BlueShield is seeking a Business Consultant, Retention Specialist, to support Medicare Advantage member experience and retention initiatives. The role is based in the greater Baltimore/Washington area with a hybrid work model, splitting time between home and CareFirst locations.

The candidate will integrate data across multiple departments, drive improvement initiatives, and develop dashboards to track progress across several ongoing programs.

Qualifications

• Bachelor's Degree or 4 extra years of relevant work experience in lieu of a degree.
• 5 years experience in business development, operational tech support, general business operations and/or consulting.
• Strong Excel and BI/reporting skills; SQL/Python preferred.

Responsibilities

• Provide subject matter expertise in Medicare Advantage member experience and retention strategies.
• Integrate data across Customer Service, Appeals & Grievances, complaints, CAHPS, enrollment, clinical, vendors, and other operational areas to understand and action on key member experience, retention, and Stars performance drivers.
• Lead implementation of enterprise improvement initiatives through project management, stakeholder coordination, and performance monitoring.
• Serve as the organization owner for driving member experience work that falls across operational teams.
• Develop dashboards to support clear communication across functional areas, monitor progress across multiple on-going initiatives.
• Business Consultant may do some member engagement/outreach work to members who provide negative survey results or have called in multiple times.

Skills

Project management

Excel

Power BI

SQL

Python

Data analysis

Stakeholder coordination

Education

Bachelor's Degree

Tools

Power BI

SQL

Python

Job description

PURPOSE

The Business Consultant, Retention Specialist, is a member of the Stars Member Experience team and provides expertise in critical work to help design, launch, and execute programs that support member experience and retention initiatives for Medicare Advantage members, driving improvement in Medicare CAHPS and HOS surveys.

Resp & Qualifications

The Business Consultant, Retention Specialist, is a member of the Stars Member Experience team and provides expertise in critical work to help design, launch, and execute programs that support member experience and retention initiatives for Medicare Advantage members, driving improvement in Medicare CAHPS and HOS surveys.

We are looking for an experienced professional in the greater Baltimore/Washington metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst location based on business needs and work activities/deliverables that week.

Essential Functions

• Provide subject matter expertise in Medicare Advantage member experience and retention strategies.
• Integrate data across Customer Service, Appeals & Grievances, complaints, CAHPS, enrollment, clinical, vendors, and other operational areas to understand and action on key member experience, retention, and Stars performance drivers. Identify member pain points, including repeat callers, and trends seen across other operational data, and do root cause analysis.
• Lead implementation of enterprise improvement initiatives through project management, stakeholder coordination, and performance monitoring.
• Serve as the organization owner for driving member experience work that falls across operational teams.
• Develop dashboards to support clear communication across functional areas, monitor progress across multiple on-going initiatives.
• Business Consultant may do some member engagement/outreach work to members who provide negative survey results or have called in multiple times.

Qualifications

Education Level: Bachelor's Degree OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.

Experience: 5 years experience in business development, operational technology support, general business operations and/or consulting experience.

Knowledge, Skills And Abilities (KSAs)

• Understands Medicare Advantage, member experience, Stars
• Follows evolving market, industry and consumer trends.
• Understands healthcare operations.
• Exceptional project management, facilitation and organizational skills.
• Understands healthcare claims, survey, clinical, and health data.
• Strategic thinker, problem solver, and a collaborator who can drive engagement and discussions.
• Advanced proficiency in Microsoft Excel and experience using business intelligence and reporting tools (i.e., Power BI), and preferred ability to conduct more advanced analysts using SQL, Python, or similar.
• Ability to synthesize quantitative data and qualitative feedback into clear, actionable business.

Salary Range

$88,848 - $176,462

Salary Range Disclaimer

The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilities of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).

Equal Employment Opportunity

CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.

Federal Disc/Physical Demand

Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on Federal health care programs.

Physical Demands

The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted.

Sponsorship in US

Must be eligible to work in the U.S. without Sponsorship