Medicare Member Experience & Retention Consultant

CareFirst, Inc.; Baltimore (MD); On-site; USD 89,000 - 176,000; Full time

Job summary

CareFirst, Inc. in Maryland seeks a Business Consultant, Retention Specialist, to join the Stars Member Experience team.

You will design, launch, and execute programs that enhance member experience and retention for Medicare Advantage members, driving CAHPS and HOS improvements. You will integrate data across customer service, appeals, complaints, enrollment, clinical and vendor data; develop dashboards; lead enterprise improvement initiatives; and coordinate across teams to drive engagement and

Qualifications

• 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.
• 5 years experience in business development, operational technology support, general business operations and/or consulting experience.
• Advanced proficiency in Microsoft Excel and experience using business intelligence and reporting tools (Power BI); preferred ability to conduct more advanced analyses using SQL, Python, or similar.

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

Medicare Advantage

Data analysis

Project management

Power BI

Excel

SQL

Python

Education

Bachelor's Degree

Tools

None

Job description

CareFirst, Inc. in Maryland seeks a Business Consultant, Retention Specialist, to join the Stars Member Experience team.

You will design, launch, and execute programs that enhance member experience and retention for Medicare Advantage members, driving CAHPS and HOS improvements. You will integrate data across customer service, appeals, complaints, enrollment, clinical and vendor data; develop dashboards; lead enterprise improvement initiatives; and coordinate across teams to drive engagement and