Member Services Advisor

Humana Inc; South Carolina; Hybrid; USD 104,000 - 143,000; Full time

Job summary

Humana, Inc. in South Carolina is seeking a Senior Member Services Advisor (Consumer Experience Lead) to enhance member engagement, retention and overall experience by leveraging customer insights, CAHPS data, and cross-functional collaboration.

You will lead the Member Experience Workgroup, drive Go365 engagement, oversee member benefits and incentives, and coordinate with multiple teams to meet market KPIs and contractual performance.

Qualifications

• Bachelor's degree required.
• Must reside in South Carolina.
• Travel up to 10% to Columbia, SC.
• 8+ years of consumer operations experience.
• 2+ years of project leadership experience.
• Experience with analytics and program evaluation.
• Strategic thinking and detail-oriented.
• Graduate degree preferred.
• Knowledge of Humana's internal policies, procedures and systems.

Responsibilities

• Improve member engagement and retention through customer insights and analytics.
• Lead the Member Experience Workgroup and drive Go365 engagement.
• Coordinate with Member/Provider Services, Transformation, Enrollment and G&A teams.
• Advise executives and develop functional strategies on member experience and performance.

Skills

Travel readiness

Project leadership

Analytics & program evaluation

Strategic thinking

Communication skills

Education

Bachelor's degree

Graduate degree preferred

Job description

About us

Humana, Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Learn more about what we offer at Humana.com and at CenterWell.com.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Role Overview

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. 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.

Required Qualifications

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

Preferred Qualifications

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

Work from Home Requirements

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees 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. In certain roles, the minimum recommended internet speed required by Humana may not be sufficient for business needs. Humana reserves the right to require associates to upgrade their internet service if necessary. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Travel

While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

$104,000 - $143,000 per year

Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and 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 and many other opportunities.