Executive Escalation Response Specialist II

Centene Corporation; Florida; Hybride; USD 25 000 - 39 000; Plein temps

Avantages offerts par ce poste

Health insurance

401K plan

Stock purchase plan

Tuition reimbursement

Paid time off

Résumé du poste

Centene Corporation is seeking a Customer Escalation Specialist in Florida to respond to complaints and escalations from members and providers. You will coordinate with multiple departments to resolve issues, perform root cause analysis, and maintain accurate records of all inquiries.

The role requires strong communication skills, familiarity with Medicare/Medicaid processes, and the ability to work across teams to implement enterprise-wide solutions.

Qualifications

• Requires a High School diploma or GED and 1–2 years of related experience.
• Strong written and verbal communication skills; experience managing executive-level escalations.
• Medicare and Medicaid knowledge preferred.
• Root cause analysis experience helpful.
• Sponsorship is not available for this opportunity.

Responsabilités

• Provides timely and appropriate resolutions to escalated issues from members/providers.
• Acts as liaison between departments to ensure timely and appropriate issue resolution.
• Supports documentation, tracking, and resolution of complaints and inquiries by writing or calling.
• Performs root cause analysis of member/provider issues to identify enterprise-wide trends.
• Coordinates with contact center to research underlying facts of escalated inquiries and evaluate remediation options.
• Reviews complaint trends and drafts recommendations to improve member/provider experience and reduce escalations.
• Maintains basic knowledge of Centene products and services to provide accurate support.
• Researches and identifies basic claims payment errors and makes appropriate adjustments when needed.
• Other duties as assigned and ensures compliance with policies and standards.

Connaissances

Escalation management

Communication skills

Medicare knowledge

Root cause analysis

Customer service

Formation

High School diploma or GED

Description du poste

Position Purpose:

Assists with responding to complaints and escalations from members/providers. Supports in handling escalations, handling problem tickets, and providing feedback to senior team members regarding member/provider issues.

Key Details:

Must be authorized to work in the U.S. without the need for employment-based visa sponsorship now or in the future. Sponsorship and future sponsorship are not available for this opportunity, including employment-based visa types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.

Prefer candidates with strong written and verbal communication skills, experience managing executive-level member escalations, Medicare and Medicaid knowledge, and root cause analysis experience.

• Provides timely and appropriate resolutions to escalated issues received from various communication channels.
• Serves as a liaison in maintaining relationships between departments to ensure timely and appropriate issue resolution.
• Supports the documentation, tracking, and resolution to all assigned complaints and inquiries in writing and/or by telephone in a timely and professional manner.
• Supports root cause analysis of member/provider issues to identify trends across the enterprise, and works cross functionally with all departments to ensure enterprise-wide solutions.
• Helps to coordinate with contact center team to research underlying facts of escalated inquiries, determine validity of complaints and evaluate options to remedy these complaints.
• Reviews complaint trends and uses guidance of senior team members to develop draft recommendations that are designed to enhance member and provider experience and reduce complaints and escalations.
• Maintains basic, introductory knowledge of our products and services to provide accurate and effective support to customers.
• In some instances, researches and identifies basic claims payment errors and make appropriate adjustments.
• Performs other duties as assigned.
• Complies with all policies and standards.

Education/Experience:

Requires a High School diploma or GED. Requires 1 – 2 years of related experience. May require vocational or technical education in addition to prior work experience. Vocation or technical education may include additional on-the-job training or continuous learning education.

Pay Range: $17.84 - $28.02 per hour

At Centene, we connect people to the care they need to live healthier lives — and the work you do here makes that impact real every day.

You’ll take on meaningful challenges that directly support individuals, families, and communities, building your skills while making healthcare more accessible and effective. It’s work with a purpose you can see, backed by a team committed to improving lives well beyond the workday.

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act