Remote Executive Escalation Specialist II

Centene; United States; Hybrid; USD 25,000 - 39,000; Full time

Benefits offered by this job

Remote/hybrid/office options

Job summary

Centene is seeking a Member Escalation Specialist to respond to complaints and escalations from members and providers, coordinating across departments to ensure timely resolution. The role supports documenting and tracking inquiries, and performing root-cause analysis to identify enterprise-wide improvements.

The position requires 1–2 years of related experience, strong communication skills, and knowledge of Medicare/Medicaid.

Qualifications

• High school diploma or GED required; 1–2 years related experience.
• May require vocational or technical education in addition to experience.
• On-the-job training or continuing learning may be involved.

Responsibilities

• Provide timely resolutions to escalated issues from multiple channels.
• Liaise between departments to ensure timely issue resolution.
• Document, track, and resolve complaints and inquiries by writing or phone.
• Perform root cause analysis to identify trends and enterprise-wide solutions.
• Coordinate with contact center to research facts and evaluate remediation options.
• Review complaint trends and draft recommendations to improve experience.
• Maintain basic knowledge of Centene products and services to assist customers.
• Identify basic claims payment errors and make adjustments.
• Comply with policies and standards.

Skills

Communication

Escalation management

Medicare knowledge

Medicaid knowledge

Root cause analysis

Education

High school diploma or GED

Job description

Centene is seeking a Member Escalation Specialist to respond to complaints and escalations from members and providers, coordinating across departments to ensure timely resolution. The role supports documenting and tracking inquiries, and performing root-cause analysis to identify enterprise-wide improvements.

The position requires 1–2 years of related experience, strong communication skills, and knowledge of Medicare/Medicaid.