Rsc Healthcare Staffing

Responsible for supporting members and other key stakeholders across the customer’s journey. They are expert on the system and understand the NYSOH processes to quickly route members to the appropriate resolution and support.

Works as a liaison to ensure proper processes are introduced and implemented such that the experience is enhanced. Provides excellent customer experience, ultimately resulting in member retention through both inbound and outbound outreach. Responsible for overseeing all aspects of member retention and being a single point of contact across all issues that are directed to the Customer Success/Customer Service department.

• Assist all line of business (Medicaid/Medicare/MLTC/CHP/EP) in retaining current qualified members by following a strategic daily work schedule that includes am and pm hours, field locations as well as weekends. This is designed to optimize telephone outreach with members due to recertify
• Follow appropriate processes to meet and exceed recertification targets set by the department
• Make the recertification process as easy and seamless as possible for our members
• Assisting members with completion of recertification applications
• Partner with different parts of the organization to understand any barriers to the member’s experience and work to resolve them appropriately
• Maintaining daily Outreach and Renewal goals set through business needs to increase overall retention Enrollment and retention support
• Assisting members with completion of all enrollment activities including but not limited to changing lines of business to ensure member is in the optimal plan, re-enrolling members due to administrative issues, premium payment etc.
• Assist members with PCP selection as well as locating providers and vendor within plan’s network
• Providing end to end customer support to drive customer satisfaction and improve customer experience
• Interfacing with internal and external stakeholders to ensure complete resolution
• Communicating verbally and in writing with members for all necessary Member Retention activities
• Devising solutions in response to member dissatisfaction/ complaints/issues to support ongoing organizational improvement efforts
• Support any ad hoc projects on process improvements
• Report common trends identified during member outreach

Education | Training | Professional Experience:

• High School Diploma/ GED - with 3-5 years of customer service experience OR
• Associate's Degree - with at least 1+ years of customer service experience
• Healthcare experience - especially Managed Care - is preferred but not required
• Bi-lingual preferred

Licensure and/or Certification Required:

***The candidate must obtain Certified Application Counselor (CAC) certification within the first month of employment. Client will facilitate the training and certification process.