Overview In this role you strengthen member relationships through education on benefits and plan usage, with local high-touch outreach to improve retention for Health Net Medicare Advantage, Part D, and CalMediConnect members. You collaborate with Customer Service, Care Management, and Sales during AEP/OEP to support enrollment changes and educate new and existing members. You will use data to identify trends, handle escalations, and engage community resources to raise awareness of Health Net programs. This is a member-centric, impact-focused position within a mission-driven organization.
Responsibilities- Act as local resource and member advocate for members
- Research call sources and perform outbound outreach to update member contact information
- Address escalated member issues to reduce disenrollments
- Coordinate with Customer Contact Center and Care Management to meet service needs
- Provide management with data and market insights on member issues
- Host informational meetings during AEP/OEP and facilitate plan changes
- Support Sales during AEP/OEP by coordinating with Field Sales and Management
- Conduct new member orientation and ongoing education sessions
- Build relationships with senior centers and community resources to raise awareness
- Maintain CMS regulatory knowledge related to Marketing and customer service
- Track and analyze member interactions to identify improvement opportunities
- Prepare reports on member retention activities to identify trends
- Participate in interdepartmental discussions to improve procedures and achieve goals
- Travel may be required occasionally
Key requirements- Minimum three years in customer service, sales, or marketing in a healthcare setting
- Medicare experience strongly preferred
- Current insurance license for the state of sale or ability to obtain within 45 days of hire
- For PA plan and Medicare only: no licensure required
- Communication
- Empathy
- Problem-solving
- Data tracking and reporting
- Understanding of CMS regulations related to marketing and customer service
- Outreach and relationship-building with community resources
