Member Services Advisor

Humana; United States; Remote; USD 86,000 - 143,000; Full time

Job summary

Humana seeks a Consumer Experience Lead to drive member engagement, retention, and overall experience across the South Carolina market. You will lead the Member Experience Workgroup, use NPS insights, and coordinate with Member/Provider Services, Enrollment, and Transformation teams.

This full-time remote role requires 8+ years in consumer operations, a Bachelor's degree, travel up to 10%, and a track record of improving CAHPS scores and driving contractual performance.

Qualifications

• Bachelor's degree required
• 8+ years of consumer operations experience
• 2+ years of project leadership experience
• Willingness to travel up to 10%
• Experience with analytics and program evaluation
• Ability to develop functional strategies to improve performance and consumer experience
• Experience identifying optimization and automation solutions
• Strong strategic thinking and planning, detail-oriented

Responsibilities

• Lead the Member Experience Workgroup and improve CAHPS performance
• Coordinate communications with members and cross-functional teams
• Develop and execute strategies to improve member engagement and retention
• Own market KPIs and performance metrics

Skills

Consumer operations

Project leadership

Strategic thinking

Analytics

Communication

Education

Bachelor's degree

Job description

Become a part of our caring community

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.

Role Overview:

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.

Use your skills to make an impact

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 experience2 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

Preferred Qualifications

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

Work at 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

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$104,000 - $143,000 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

• medical
• dental
• 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
• many other opportunities

About us

About Humana: 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