Medicare Retention Specialist - CA
Posted on: 18 Mar 2021
Santa Ana, CA
Job Description
Job Description
Local market Retention Specialist is responsible for implementing the local market operating plan for retention. Collaborates closely with the corporate retention team and execute on retention strategy as an extension to segment best practices/resources. Analyze the membership data to produce reports and retention activities to address member issues and mitigate lapses. Serves as a member relations liaison to ensure optimal member experience. As a member of the Operations team, will assume operational projects that impact the member experience; such as material and product review during the BID and sales cycle. Trends/categorize issues & interventions to address potential & existing member issues. Maintains work in process log, accountability & time in process. Facilitates, co-manages local member experience related team meetings. Plays a critical role in retaining members and working with other departments to coordinate issues resolution and provider insights/recommendations to leadership and external stakeholders (i.e., medical groups)
Knowledge of Medicare business and the CA IPA model to best serve the senior membership. Project management experience in a provider, hospital, health plan or related healthcare or community organization setting with member activities Strong verbal and written communication skills.
Team player with strong organizational skills. Experience with customer service. Ability to document, follow thru & solve health plan or healthcare access/service issues with seniors, brokers and or providers.
Required Qualifications
Strong Customer Service Experience.
Communication and computer skills a must with 5 years +
Preferred Qualifications
Licensed Life Agent - Preferred
Medicare business experience - Preferred
Bi-lingual candidate preferred but not required
Education
4 year college education
Business Overview
At Aetna, a CVS Health company, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.
We are committed to maintaining a diverse and inclusive workplace. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, gender, gender identity, age, disability or protected veteran status. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.
Aetna
Hartford, CT
Aetna Inc. operates as a health care benefits company in the United States. It operates through three segments: Health Care, Group Insurance, and Large Case Pensions. The Health Care segment offers medical, pharmacy benefit management service, dental, behavioral health, and vision plans on an insured and employer-funded basis. It also provides point-of-service, preferred provider organization, health maintenance organization, and indemnity benefit plans, as well as health savings accounts and consumer-directed health plans.
In addition, this segment offers Medicare and Medicaid products and services, as well as other medical products, such as medical management and data analytics services, medical stop loss insurance, workers’ compensation administrative services, and products that provide access to its provider networks in select geographies. The Group Insurance segment offers life insurance products, including group term life insurance, voluntary spouse and dependent term life insurance, group universal life insurance, and accidental death and dismemberment insurance; disability insurance products; and long-term care insurance products, which provide the benefits to cover the cost of care in private home settings, adult day care, assisted living, or nursing facilities.
The Large Case Pensions segment manages various retirement products comprising pension and annuity products primarily for tax-qualified pension plans. The company provides its products and services to employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups, and expatriates. Aetna Inc. was founded in 1853 and is based in Hartford, Connecticut. As of November 28, 2018, Aetna Inc. operates as a subsidiary of CVS Pharmacy, Inc.
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IndustryInsurance
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No. of Employees47,950
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Website
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Jobs Posted12677
