Specialist, Medicare Member Engagement-Bilingual-(Remote)-PST hours

Molina Healthcare; Lexington (KY); Remote; USD 60,000 - 80,000; Full time

Job summary

A leading healthcare organization based in Kentucky seeks a member advocate responsible for enhancing member engagement and retention. In this role, you will conduct outreach to new Medicare members, navigate onboarding processes, and ensure members are informed about their plan benefits. The ideal candidate has at least 2 years of customer service experience, preferably in healthcare, along with strong communication skills and a commitment to member support.

Benefits

Competitive benefits and compensation package

Equal Opportunity Employer (EOE)

Qualifications

• 2 years experience in customer service or health care systems required.
• Basic understanding of managed healthcare systems and Medicare.
• Experience with Medicare managed plans is preferred.

Responsibilities

• Conduct direct outreach to new Medicare members.
• Serve as the member’s navigator during the onboarding process.
• Log all contacts in a database.
• Participate in member engagement work groups.

Skills

Customer service experience

Consumer advocacy

Excellent communication skills

Bilingual

Education

High School diploma

Associate's or Bachelor's Degree in Social Work or related field

Job description

Job Description

Job Summary

Responsible for continuous quality improvements regarding member engagement and member retention. Represents Member issues in areas involving member impact and engagement including: New Member Onboarding, member plan benefits education, and the development/maintenance of Member Materials.

Knowledge/Skills/Abilities

• Conducts direct outreach to new Medicare members to provide personal assistance with their new MAPD, DSNP, and MMP plans. Serves as an advocate to ensure members are well informed about plan benefits, provider options and how to use their new plan benefits.
• Serve as the member’s navigator during the onboarding process and address any plan questions and anticipate any issues that may arise. Determine the nature of the member's needs and interests; inform members of their plan resources and benefits with a focus on the member’s area of interest/needs; and follow up with member to ensure needs are met and member is having a positive plan experience. Develop relationship with member to be the go-to person with any future issues or questions.
• Log all contacts in a database.
• Participate in Member engagement work groups as needed to ensure Medicare member needs are being anticipated and addressed.
• Participates in regular member benefits training with health plan, including the member advocate/engagement role.
• Bilingual

Job Qualifications

REQUIRED EDUCATION: High School diploma.

REQUIRED EXPERIENCE: 2 years experience in customer service, consumer advocacy, and/or health care systems. Experience conducting intake, interviews, and/or research of consumer or provider issues. Excellent written and verbal communication skills to collaborate internally and externally with members, providers, team members, and manager. Basic understanding of managed healthcare systems and Medicare.

PREFERRED EDUCATION: Associate's or Bachelor's Degree in Social Work, Human Services, or related field.

PREFERRED EXPERIENCE: Experience with Medicare and Medicare managed plans such as MAPD, DSNP, and MMP.

To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.

Pay Range: $21.16 - $34.88 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.